Galen Partner Advisory Council (GPAC) 2014

Galen hosted its second annual Galen Partner Advisory Council (GPAC) event in Chicago on August 11-12th. GPAC is a time for us to meet with our clients to discuss the major changes our industry is currently experiencing and share where Galen is headed. For 2014, we continued on a 2013 theme: a focus on value-based care. On Day 1, whether the session centered on care coordination, EHR conversions, or analytics, the common theme was how our world is changing to accommodate the shift toward value-based care. On Day 2, we had a chance to discuss a few topics outside of value-based care, where our clients had very specific, very near-term interest: MU2 planning, Clinical Documentation Improvements for ICD-10, and for our Allscripts clients, the move to the Common Interface Engine.

Galen hosts this event with our leadership team and a handful of our KLAS-rated subject matter experts in the various areas of discussion. Individuals from over a dozen client organizations joined us at GPAC, which included senior management, physician champions, and experienced EHR analysts from throughout the country. Attendees included clients from our Allscripts and MEDITECH practices, which we plan to continue expanding on next year. GPAC strives to foster a collaborative environment for sharing of ideas, while providing valuable information to each organization that attends.

Here’s my take on the individual sessions we had together:

  • Joel Splan, Chief Executive Officer, provided his insights on the healthcare IT industry today. We focused on the impact of value-based payment systems projected to replace the fee for service model, increases in mergers/acquisitions, the many challenges in MU 2, and decreases in the number of EMR vendors. Joel then focused on the challenges of care coordination, a critical area for improvement with value-based care. Pinpoint Health’s solution offers configurable care plans, patient preferred communications, and intuitive user experience, all with an affordable, rapid return on investment.
  • Julia Snapp, Managing Consultant – Epic, and Michael Tamlyn, Software Architect, presented on managing risks and controlling cost on EMR conversions. With the increase in mergers and acquisitions, having clear paths to quickly convert EMR data from one system to the other and streamlining that process was reviewed. Highlighted areas included engaging experts quickly, providing access to resources quickly, and procuring clinical resources to validate the clinical data.
  • Rita Owens, VP – Clinical Solutions, closed out Monday’s session leading a client discussion on value-based care and analytics. Most participants identified that there were too many data feeds from payers with data delayed by several months. Additionally, most feeds don’t have the cost to provide care in a systemized way, and the feeds only allow for basic reporting capabilities. The GPAC group discussed lack of incentives in this area overall and didn’t feel healthcare was there yet, but know it is coming.
  • Rita started Tuesday’s presentations with ICD-10. We focused on the clinical documentation improvements and requirements to go along with the ICD-10 codes to ensure proper payment. Rita demonstrated some of the note template updates Galen has modified for our clients, in both MEDITECH and Allscripts, that assist these organizations in meeting ICD-10 documentation requirements for payment, while making it easier for clinicians to document what’s needed.
  • Christy Erickson, Lead Consultant, provided a Meaningful Use update with a client discussion on the current challenges of MU2 implementations. One quarter of the group is currently trying to attest for Stage 2, with the remainder planning to begin attestation in the fourth quarter. Key workflow struggles discussed were e-referrals, patient reminders, and patient engagement.
  • Justin Campbell, Director – Technical Services, closed out the session on Tuesday with a discussion for our Allscripts clients migrating to the Common Interface Engine. He gave a no-nonsense overview of the planning consideration when migrating from ConnectR to CIE/Rhapsody. Our clients provided their input on how some of their current planning/migration work was going, along with the challenges encountered so far. We agreed the primary benefits with migrating to CIE/Rhapsody were ease of use, and the increased reliability and scalability the platform affords.

We want to thank the individuals and organizations that joined us for the 2014 Galen Partner Advisory Council. All showed active involvement in this meeting, and bring tremendous value to Galen. Our clients indicate that one of the best things about GPAC is the chance to connect with colleagues across different areas of the country to discuss the rapidly-changing healthcare scene.

Chart1-OpeningComments

Allscripts Common Interface Engine – Why? When? How?

At this point most have likely heard the “What?”.  What is CIE or Common Interface Engine (Rhapsody 4.1 currently) and what are the benefits of switching to CIE (ease of use, features, better vendor support, etc.). Now the questions have really turned to the “Why?”, “When?”, and “How?”.  Why are we doing this now? When do I need to make the switch? How should I go about making the switch?

Why are we doing this now?

ConnectR is an antiquated software long overdue for replacement. We haven’t seen updates or support for it in a number of years and we have had to learn to live with quirky issues we experience in ConnectR. However, the real driver is the end of standard support this year for MS SQL Server 2008. This is the last supported version of MS SQL Server for Connect 4.6, which the last supported version of ConnectR for Allscripts TouchWorks.

When do I need make the switch?

In all honesty, when it makes sense for your organization. Yes, SQL Server 2008 standard support ends this year, but don’t let that cause you to rush into doing something immediately. Many clients only switched to using SQL Server 2008 in the last year and some are still running SQL Server 2005. Standard support for SQL Server 2005 ended in 2011. With that, an end to SQL Server 2008 standard support is not going to change anything or have any impact immediately and ConnectR is not going to stop working next year. The level of support you get for ConnectR should not change anytime soon either. My recommendation is, don’t rush, but start planning. Start planning it into your project list and budgets. Start getting your hardware ready and get your request in to get CIE installed.

How should I go about making the switch?

We have received a lot of questions about approach, strategy, and timeline for migrating from ConnectR to CIE. The answers to these questions all depend on your ConnectR environment. How many interfaces do you have and what types of interfaces do you have? Start by getting an inventory of your interfaces. If you have more than 10 interfaces you will want to consider breaking them in to groups and migrate them in phases. There are no technical limitations to running ConnectR and CIE side-by-side. I recommend scheduling the phases as it makes sense for your organization and as it fits into your project schedule. Look at migrating your simplest interfaces first. Keep in mind that all of your outbound interfaces will need to be migrated at the same time as they are all reading from the same source.

Have more questions? I am passionate about this topic and enjoy talking through it with clients. Feel free to reach out to me directly at ray.lape@galenhealthcare.com, or any of your Galen contacts to talk more about your CIE Migration project.

The Allscripts Client Experience

The Allscripts Client Experience (ACE) took place from Aug 12-15 in Chicago. Allscripts dominated the HUB floor with multiple sections dedicated to their various products lines and services. Galen hosted a booth in the partner pavilion, and while it was a bit smaller than it had been in previous years, Galen maintained a steady flow of attendee traffic. This included many new faces, old friends, and current clients, all of whom were curious about our products, and who showered praise on numerous Galeneers for their assistance with upgrades, conversions, and implementations!

ACE Booth 2014

This year Galen featured its products eCalcsTM, VitalCenterTM, and Dragonfly – Galen’s latest product for remote patient monitoring which garnered a lot of excitement!  The Galen team was constantly engaged in conversation with visitors and eagerly gave demonstrations on all the products. The Galen booth’s theme was “Possibility” with an emphasis on IT, to promote the idea that Galen is much more than just an IT company. The prominently displayed theme captured many attendees’ curiosities, and visitors were given a chance to enter a raffle to win Withings products including a wireless weight scale, wireless blood pressure cuff, and an activity tracker. Raffle winners to be announced soon!

Our Product Manager, Steve Cotton, was also invited to present a session on eCalcsTM during the conference. The presentation took place in a separate classroom allowing Galen’s presence to extend beyond the HUB. Attendees were inquisitive about the product and even shouted out a few suggestions for new calculators! Thank you to all of our clients and friends who attended all of the Galen sponsored events, including Lucky Strike bowling on Wednesday and a night out at Studio Paris Nightclub on Thursday!  The air was definitely abuzz with the big Allscripts announcement that ACE will be held in Boston next year, and we look forward to seeing you then!

So Many Consultant Groups…So Little Time

As Healthcare Information Technology (HIT) grows into a bigger and more complex world, many physician offices and hospitals find that they need additional help.  This assistance is not only needed for optimizing EHR implementations and clinical system workflows, but also with initiatives such as Meaningful Use, PCMH, and Insurance Performance Measures/Quality Measures.  Several consulting groups reinvest time in developing curriculum and educating their consultants to be experts in the field; Galen Healthcare Solutions is one of those groups.

“Perpetually Learn and Share” is one of the 5 Main things Galen strives for to distinguish itself from others in the industry.  From day one, new hire consultants at Galen go through a comprehensive, home-grown Allscripts TouchWorksTM EHR course developed by our very knowledgeable and experienced subject matter experts.  The course culminates in a multi-part exam that includes written portions as well as system configuration scenarios, which the new consultants must pass (with flying colors) before progressing any further at Galen.

Galen consultants strive to continuously develop skills, stay ahead of the dynamic industry curve, and share that knowledge with others.  Along those lines, Galen has developed advanced internal certifications that its consultants obtain across various Allscripts TouchWorksTM EHR modules, such Charge, Orders and Results, and Notes.  Although brutal to go through, once passed (again with flying colors), that consultant is considered an expert in that particular module.

Not only are Galen consultants perpetually learning, they share that knowledge amongst not only themselves, but with the HIT community at large.  Whether it be through the Galen Wiki, public webcasts, or a quick comment on Client Connect, Galen offers information and provides transparent resolution to issues, and is always willing to help out and share its experiences with others.

When it comes to choosing between the various options, don’t hesitate to inquire if a group provides continuing education for their consultants, and if so what that education consists of.   The more knowledgeable a consultant is, the more valuable they will be for you.

You say CCD, I say CDA – what’s the difference?

With Meaningful Use comes document exchange, and with documents having similar acronyms, it is hard to keep them straight. The common acronyms used with document exchange are CDA, CCD, and CCR.

A Clinical Document Architecture (CDA) is an XML-based markup standard intended to specify the encoding, structure, and semantics of clinical documents for exchange. Similar to Microsoft Word, it can include text, images, sounds and other multimedia content. Some examples of a CDA document would be a Discharge Summary, Imaging Report, Admission & Physical, Pathology Report, or any content that potentially carries a signature. The CDA standard doesn’t specify how the documents have to be transported. Therefore, the documents can be transmitted using HL7v2, HL7v3, IHE protocols such as XDS, DICOM, or MIME attachments to email, http, or ftp. A CDA must contain a human readable section and optionally can contain structured sections. Structure sections, also known as machine readable, are the sections of the CCD that allow for data to be imported discretely into the Electronic Health Record. The most current version of the CDA is Release 2 which came out in 2005. CDA R2 allows for greater encoding complexity, but still allows for the lower level encoding used in CDA Release 1.

The Continuity of Care Document (CCD) is the most commonly used CDA document. Prior to the publication of the CCD, a Continuity of Care Record (CCR) was released, with the assistance of several other groups, by ASTM International. A CCR provided a summary of the patient’s health status that would be useful to another provider if available at the time of the clinical encounter. Within the healthcare industry, there was a divide growing as to which messaging standard to use. Some preferred ASTMs CCR while others have adopted HL7 International’s CDA. As a way to bridge the gap, the CCD was developed as a joint collaboration between the HL7 and ASTM organizations. A CCD is an electronic patient summary document used to share the most commonly needed information about a patient’s past and present health status. Some of the sections that you will see in a CCD are Problems, Family History, Social History, Allergies, Medications, and so on. A CCD uses encoded XML, therefore it is viewable via the import but can also be imported into an EHR.

CCD v CDA

If you are interested in gaining a more in depth knowledge of the CCD data types, sections, and entries I will be presenting a webcast on Wednesday, 8/27. The details and registration information can be found at http://www.galenhealthcare.com/event/advanced-hl7-cdaccd-or-fhir/.

 

Next Page »