Clinical Quality Measures

Clinical Quality Measures

Clinical Quality measures are metrics introduced by CMS to improve patient health, patient care, and lower costs. Currently there are 29 CQMs which fall under six domains:

  1. Patient and Family Engagement
  2. Patient Safety
  3. Care Coordination
  4. Population/Public Health
  5. Efficient Use of Healthcare Resources
  6. Clinical Process/Effectiveness

Eligible professionals are required to report on nine CQMs that fall under three of the six defined domains. In addition Meaningful Use requires that Clinical Decision Support interventions are applied to four of those Clinical Quality Measures.

As a result simply identifying which domains, CQMs, and CDS your organization will be using for your eligible professionals can be a time complicated process. Now factor in the configuration, LOINC codes, SNOMED codes, CPT codes, training, etc. and it can start to become overwhelming.

That’s where Galen can help.  At Galen we can start by helping with the identification of which CQMs  are most appropriate for you EPs. Once CQMs have been selected we can assist with configuration and workflow training. Finally we can assist in the quality assurance of your reports to ensure that your organization is receiving the most accurate data possible. If your organization has any questions regarding CQMs for your EPs please contact us and we would be happy to assist.

Got Big Data? #tdwiOR2014


We attended a great analytics conference in Orlando this week. To start, let’s be clear that Florida as a destination was not as attractive as you might think – it was 40 degrees while we were in town!

The conference, TDWI Orlando, is part of a series of conferences held by the analytics industry group, The Data Warehousing Institute. TWDI has been around for nearly 20 years as the BI/analytics space has evolved from its meager roots to being a subject covered by magazines like The Economist and the Harvard Business Review in recent years. What we liked about this conference was the cross-industry focus – it wasn’t just healthcare, which is arguably behind the times with analytics. Chilmark Research, a healthcare IT research firm, wrote a glowing review of the conference last year, which prompted us to take a look at this years’ event.

We attended a variety of sessions, often dividing and conquering the available education tracks. Here’s a quick overview of what we found.

Traditional data warehousing and ETL processes are alive and well. This is the core of any analytics strategy, including big data. Even the groups who are focusing heavily in Hadoop continue to rely on their relational data warehouse for a significant portion of their analytics. Big data continues to lack definition – from debates over the validity of the three Vs to what defines “Big”.

When discussing predictive analytics, it was stressed and thoroughly debated that these new techniques are not a replacement for traditional dimensional data warehouses. If anything, new techniques can be used to augment available information on reports. In many cases, it’s prudent to feed data generated by predictive analytics and data mining exercises back into a data warehouse for reporting, trending and future evaluation of effectiveness.

Hadoop is here to stay, and is gaining traction within healthcare. Some research suggested that as laggards in technology adoption overall, we in healthcare are positioned to leapfrog many other industries who are weighed down by investment in traditional analytics tools. Qlik and Tableau are widely regarded by the industry as the best data visualization and data discovery tools out there.

Social media in business isn’t just for engaging consumers anymore. Sure, companies like Comcast and United have had their ups and downs with engaging their customers on social media, but companies are increasingly monitoring and mining feeds from Twitter, Facebook and even Pinterest to understand their markets better and how customers view their brand. Most social media have their public feeds, though serious social analytics requires the use of Gnip or DataSift.

People are still a huge part of any BI & Predictive Analytic program. Looking at the CRISP-DM (Cross Industry Standard Process for Data Mining), business understanding is at the top. Without a clear understanding of how the business operates, and what the needs are, and exercise could be thought of as a R&D venture with no direct impact on the business. Trust and Accountability are also huge factors to be considered. In many business sectors, new C-Level positions are being created with the purpose of assigning responsibility and accountability for these new ventures. After all, if no one is accountable, how can anyone trust the data.

We have heard a lot about analytics in the healthcare space as accountable care and population health management seem to have overtaken our world in the last couple of years. The TDWI conference was a great chance to escape from this world, and see what’s happening in analytics across industries.

Allscripts TouchWorks™ v11.4.1 HF9 introduces fix to custom order status reason


I would like to take this time to follow up on a previous blog article done last year by my colleague, Tyler Yoder, about Creating and Applying Custom “Hold For” Reasons. Prior to Allscripts TouchWorksTM v11.4.1 hotfix 9, a custom order status reason could be created for all order statuses, however it would not hold when applied to an active or in progress order, and could not be filtered out in a worklist. The v11.4.1 HF9 release notes indicate that this has now been fixed to work for status reasons linked to “Active” or “In Progress” status.

From the HF9 release notes:

Previously, you could not add an order status reason for all order statuses; Active and In Progress orders were excluded. This issue has been resolved so that you can add and remove non-enforced order status reasons through the Change Status page on all order statuses, and you can do it without changing the order status. This functionality facilitates the use of worklists views that filter on Order Status Reason.

In practice, this enhancement could help to streamline multiple organizational workflows. The referral coordinators at one of my client sites use a custom worklist to track referral orders once they are scheduled, as they don’t want to keep the orders in a “Hold For” status. The custom worklist allows the coordinators to monitor “Active” referral orders for follow up until they confirm that the appointment took place. They also wanted the ability to track active referral orders with a higher level of granularity, and the functionality to configure other types of active status reasons will allow them to filter down their worklists even more effectively.

Although not all organizations will benefit from this new functionality, it is at least worth pointing out that custom order status reasons can now be utilized on all order statuses with future releases of the TouchWorksTM application. To see how to create custom order status reasons and how to apply them to orders in the OID (Orderable Item Dictionary), please refer to the blog article mentioned above.

New TWUserAdmin Preferences in 11.4.1


In June 2014, information was posted to the blog regarding new TW User Admin Preferences in Allscripts TouchWorksTM 11.4.1.  Although the focus of 11.4.1 is Stage 2 Meaningful Use (MU2), there are lots of under-the-radar enhancements to the application for daily functionality.  Some of the enhancements in 11.4.1 include the ability to assign all sites or specific sites to a user’s primary organization, the ability to add multiple licenses and ID’s, and the ability to have the Provider Details in one section.

The user copy functionality will copy all views (i.e. chart view, clinical desktop views, task views, worklist views, and patient list views), and therefore it is recommended to copy a user in the same role and from the same site if possible.  An organization could also consider building user templates from which to copy (ORGFrontDesk, ORGProvider, etc).

There is an extensive Galen Wiki article here that will walk you through TW User Admin with the 11.4.1 changes. In addition, we have added the User Copy functionality to the article.  Building users can be a tedious task and this functionality makes adding new users manually a much quicker process.

Unlocking Imagination: Galen at TEDMED 2014

“Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.”

― Albert Einstein


TEDMED is a different kind of gathering – unlike a traditional conference, where you are tasked to learn specific things, or a trade show, where you are asked to learn about new products and make connections. At TEDMED, we were asked to think collaboratively – to listen to stories about how curiosity, frustration, or life events inspired individuals to look a little differently at the problems they were facing and imagine a new solution. This is how we began our conversation at TEDMED 2014, a conference that focuses on the intersection of Technology, Entertainment, and Design, as it pertains to healthcare. Over the course of three days, 80 speakers shared their stories from two stages, with approximately 1600 delegates in person and thousands more around the world watching the event via live feed.

Steven Hawking once said, “The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge.” It takes a certain amount of courage and vulnerability to approach the world and your work with the mindset that you do not know everything – fostering a mindset like this one can be both liberating and empowering. My co-workers consist of an incredible array of experts – developers, nurses, process and product experts. We are lucky enough to work for a company that embraces the idea that it is not our knowledge that sets us apart. Our knowledge, combined with the notion that we all have the ability to perpetually learn and share, is what sets us apart. Imagination is a part of our culture, and it is a critical tool we use to make the leap from implementing a product, to engaging in processes that helps us discover what a client needs in a product to best meet their goals.

Spending three days at TEDMED, I met a neurologist who teaches communication skills to medical providers, a woman who transforms prosthetic devices into works of art, a man who custom builds workspaces for medical providers, a cardiologist who has written about things human medicine can learn from veterinary medicine, and finally a college drop-out who has built a new, efficient, painless, and cost-effective way to approach lab tests. Everyone that I met had one thing in common – at some point in their work life, they thought “There has to be a better way…”

In my daily work, I engage with System Administrators and Super-Users to ensure that their electronic medical record system is and will continue to work effectively for the end users in the future. My work requires that I remain nimble as changes in legislation and software happen often. Implementations, conversions, optimizations, and custom solutions do not just require experts – they require imagination. We have to look creatively at each challenge presented to us in order to come up with the best solution for the client that we are working with. To step out of my world for a few days and sit with scholars, inventors, and thought leaders was indeed a privilege. In another way, it was like coming home.

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