Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

As many of our loyal blog followers know, the Allscripts Client Experience (ACE) is Allscripts annual user conference, and a huge event for Galen. It’s a time for us to reconnect with clients, Allscripts contacts, and build new relationships. The theme of this year’s conference was “GO” – the time is now to implement an EHR, and ensure groups are setup to exhibit Meaningful Use.

Some of my own key highlights and takeaways from ACE:

• “The Path to Meaningful Use”
  • Allscripts offered a handy trail guide for ACE:

• The theme of “Community”
  • Our CEO, Steve McQueen, exhibited some pre-conference foresight in lending his own insight into Galen’s community
  • MyAllscripts - client portal for all Allscripts products facilitating collaboration via discussion forums, enhancement idea exchanges and blogs.

• Analytics
  • Dan Mingle, Chief Physician Execute from Maine MSO and Dan Reber, Lead Product Architect at Precision BI led an informative session on the Analytics product, touching on the correct process to implement Analytics as well as using the cross-tab analysis and linked group analysis.
  • I was unaware of its existence, but a user group community has been established for analytics
  • Precision BI has a roadmap for several improvements

• Aternity – an Allscripts performance monitoring solution
  • The ideal tool is non-invasive, comprehensive, accurate and provides an aggregated analysis
  • Facilitates user-centric proactive IT management
  • Yields performance by location, variation by site, and performance over time

• Allscripts Product Portfolio Roadmap – Jon Zimmerman, Allscripts Senior VP Solutions Management
  • Revenue Mix Changes:
    • Today: Fee for Service and Bonus Payments
    • Tomorrow: Fee for Service, Bonus Payments for Savings, Contract per Patient per Month, and Other P4P
  • Systems Evolution
    • Paper Health Records -> Electronic Health Records -> Electronic Health Systems -> Intelligent Networks
  • Connectivity Blueprint:
    • Allscripts HUB: Connecting commercial lab, hospital, pharmacy, payer, HIE, government registries, and sate RHIO
    • Services Framework: EntEHR, PM, ProEHR, MyWay

For more information regarding the topics touched on above, be sure to visit MyAllscripts to view presentations from ACE.

Thanks again for everyone who stopped by our booth to say hello. It was both great to see old friends and establish new relationships. And a special congrats goes out to Melissa Singh, Analyst at NSLIJ, for winning the grand prize – an Apple IPAD – in our “Spin and Win” drawing.

Tags: Allscripts, Allscripts Enterprise EHR, EHR Implementation, Enterprise EHR, Meaningful Use

It is with no small sense of pride that we at Galen Healthcare Solutions embrace our role as a leader in moving our community the Allscripts User Community towards its collective vision of improving health care through the use of technology.

Even before our inception nearly 5 years ago, our people have demonstrated an understanding that to achieve our individual goals, we must recognize the value in sharing our expertise and experiences with organizations across our industry that has similar objectives.  We know that to be successful, we must be willing to lend assistance, because we most assuredly will need the support of others from time to time.

It is because of this belief system that we make our combined knowledge freely available to whoever needs access to it through our Galen Wiki and Galen Blog.  We encourage every member of the community, user or vendor, to participate in this free exchange of information with the mindset that we are all in this struggle together.

Further, we are thrilled to introduce a new program in this newsletter where we give our readers an opportunity to increase and direct the body of knowledge that we publish on our wiki by “Asking an expert.”    Users can submit questions to our website and our team of experts will review the questions and use them to direct future content for the wiki.

Additionally, and with the concept of advancing the global effort in mind, we believe strongly in supporting the various regional and niche user groups currently active across the country.  We are witness to the power of these groups nearly every day.  We see email conversations involving dozens of organizations spanning several states sharing concepts with the intention of helping each other move past their obstacles.  We see thousands of users joining to form a single voice demanding resolution to persistent issues.  And we see the times when these groups gather physically, in a single location, to share their experiences, frustrations, and success stories all in an effort to support one another and move forward

We are, of course, in the midst of yet another injection of uncertainty in the form of “Meaningful Use”.  As a result, it appears that ACE 2010 couldn’t come at a better time.  Certainly, ACE is a great opportunity to see old friends and make new ones, but more importantly, it is a chance for the community to convene, give voice to its anxieties, and discuss steps to overcome them.  We relish the chance to participate in that process.

We hope that each of you attending ACE 2010 will stop by our booth, have a little fun (Spin to Win an iPad!), and share your thoughts, voice a concern, or just ask a question.  We know that the success of our organization depends on the success of the community overall.  We, collectively, can achieve that success through a commitment to promoting the greater objectives, freely sharing our knowledge, and continually moving the community concept forward.

Enjoy your summer and I hope to see you at ACE.

Steve McQueen

Tags: Allscripts

Last night, my colleagues and I attended a New England HIMSS event in Wellesley, MA covering Mobile Health. After battling through brutal traffic commuting from Boston to Wellesley during rush hour, we arrived and were all equally impressed with the night’s speaker -  Robert Havasy, Business Analyst at the Center for Connected Health in Massachusetts. I particularly liked the presentation technology used for his pitch – Prezi - a web-based presentation application and storytelling tool that uses a single canvas instead of traditional slides.

Some key takeaways from the presentation:

• Will the FDA regulate smart phones or mobile devices and treat them as medical devices?
• Patients are unencumbered by the regulatory process
• Two focus areas for mobile health technology
  • Capturing Data – vitals, blood sugar, etc
  • Coaching – guiding patients to make better choices
• Sunscreen adherence using mobile technology
  • Electronic monitor used to accurately measure usage of sunscreen
  • Reminder texts sent to mobile phone
  • After six weeks adherence rates for the reminder group were almost double that of the control group who did not receive reminder texts: 56 versus 30 percent.
• Utilizing text messaging to influence patient behavior -Center for Connected Health – project in Lynn, MA.
  • Two areas of focus: Opiate addiction and Teenage pregnancy
  • Localization is important – mention people by places and name
  • Who the message was from (especially doctor) meant more to patients that if it were personally addressed to them
  • Barrier to participation – cost – patients were afraid they would have to pay for the additional text messages
  • Unleash the nurses – nurse evangelist sells benefits to non-physician staff
  • Offset workflow changes in offices – take administration off of practice
  • Sustainable reimbursement structure – engage carriers – CMS – insurers – alternative quality contracts
• Northeastern University, working in collaboration with industry players, announced an incubator program for mobile health technologies. Contact Dan Feinberg, Director, Graduate Health Informatics Program at Northeastern University, President at New England Chapter of HIMSS, for more information

Tags: ehealth initiative, Extensibility, Integration, Interoperability, Meaningful Use, mHealth

Last Friday, I attended Governor Deval Patrick’s HIT conference in Boston and present my own musings and takeaways from day 2 of the conference. Be sure to check out Dr. John Halamka’s reactions from last Thursday morning’s CEO summit at the Govenor’s HIT Conference.

Keynote from the Surgeon General – Vice Admiral Regina M. Benjamin

• She covered how Hurricane Katrina affected her community in Alabama and the fact that due to the natural disaster, they were reliant on pharmacy chains to provide a record of what medicine the patients were taking.
• She also touched on a story of how members of her clinic were drying out the patients records after Hurricane Katrina and after they had them completely dried; a fire burned the entire clinic down. This brings to light the need for disaster recovery and collocation in some circumstances. Galen Healthcare Solutions proudly offer a downtime solution in its VitalCenter product.
• After the fire, Bentley college students came down to assist and one of those classes contacted the president of e-ClinicalWorks and convinced him to donate the EHR – integrated with both labs & referrals
• She stressed that prevention is the foundation to the National health System and as such we should be incentivizing prevention.
• She also mentioned how the EHR played a major role in prevention of errors

Getting Clarity – Developing Effective Health IT Policies and Standards

• Need to integrate claims and clinical data to provide total model for exchange
• 15 cents of every dollar in healthcare goes to administrative overhead
• Two key issues for data exchange – identity and consent
• Public Health entities currently receive data, however not every public health entity has the infrastructure to receive data
• How do we pull quality measures out of unstructured text?
  • Analogy of querying for alcoholics, but free text match is returned about using alcohol to swab skin before applying needle.
• The tough part of concerning clinical quality measures is the balance of structured and unstructured data
• Healthcare delivery is complex in that there is heavy fragmentation – 80% are solo or two physician practices
• Dr. John Halamka mentioned that we are the stewards of our own data and architecturally that is the design of the system

Jobs, Jobs, Jobs – Health IT, Business Opportunities, and Job Creation

• Healthcare workers do not have not enough IT in their educational curriculum
• Howard Messing, the President of Meditech mentioned that in Massachusetts in particular the cost of living is a barrier – Meditech actually has commuters from Atlanta.
• Girish Kumar Navani, CEO of e-ClinicalWorks indicated that they currently employ greater than 1000.
  • He anticipates hiring 500 new workers over the next 2 years for programming and business analyst positions
  • He also mentioned the analogy of the electrical socket – broadband network need to be as irreplaceable in physician office as the electrical socket.
  • He believes there is a need for a  new type of worker, the knowledge worker, who understands workflow and is able to analyze and make better decisions about population health
• Richard Reese, Executive Charmain of the Board, Iron Mountain, anticipates helping hospitals clean up paper mess.
  • He mentioned non-compliance in healthcare IT to storage and backup standards
  • Lesson in compliance can be drawn from Wall Street years ago and that healthcare organizations must design for workflow, but compliance as well
• Brad Waugh, President & CEO at Navinet, indicated that the network his company providers connects payers and providers, saving $800 million per year.
  • They currently require Microsoft .NET certified engineers and have over 30 openings
  • He indicated that the educational system must produce the folks needed in healthcare IT and currently it is just not doing so domestically
• This discussion brought to light a deeper seeded issue in American society in that as a society we are not pushing computer technology anymore as it is no longer the glamorized industry.
• There is a major need for qualified issues and it is a supply versus demand issue with the roots in education and society.
• One member of the audience mentioned that the goal of healthcare reform is to eliminate costs and the irony is that in a sense we are creating jobs to eliminate jobs
• Another member of the audience commented on the arrival of programs for night healthcare professional courses, much like it was the trendy thing to get a night MBA in the 90s
• Finally the point was made that by the middle of the current decade, we will be facing baby boomers hitting Medicaid and the amount of care they need is incredible. With less dollars, we will need to re-engineer the system and what could come as a result is care rationing

Panel: Successful HIEs – How They Did It and How It Helps

Fallon Clinic HIE

• Emergency care was the highest reason for HIE usage
• Some quotes from physicians on the value the HIE provided
  • “Importing the CCD expedited documentation”
  • “Reduced need to ask patients questions”
  • “Expedited verification of medication and allergy list”
  • “Saved time”
  • They estimate phone calls were avoided for 75% of hospitalist and were extremely beneficial for new patient visits
  • They estimate they spent 3 years and $3 million learning and developing “trust” and $1M in building and implementing in the final 2 years
  • Lesson learned:
    • They pre-registered all of their patients in the community (bulk-load) and this helped with performance as they didn’t have to query the state
    • They felt the key to sustainability was to reduce operating expenses
    • Each organization in the HIE was responsible for server maintenance – ends up being $2000/year/organization which represents rounding error in most healthcare IT budgets
    • Key points – earn trust – utilize real-world workflows – value of low cost

Indiana Health Information Exchange

• Federated data model – 62 hospitals – 3 billion structured results – doubling time of 4 months
• They meet the providers where they are whether it be delivery of data to the EHR or physicians receiving data as PDF or view into a portal
• They view sustainability in the sense of funding via offering services
  • work with public health services for syndrome surveillance and track immunizations
  • Their business model for sustainability is such that scale is needed and again they emphasized avoiding grants for operational costs.

NEHEN

• Their sustainability model is such that their organization provides governance – decide what has value – much as a board of directors would
• Federated model works better than centralized – more accepted in the marketplace
• Lessons learn include integrating processes across the enterprise
• The case of the transfer of information to public health is needed to sustain HIEs as well as the capability to sell other products within the network.

Tags: Adoption, Business Continuity, HIE, HL7, Immunizations, Integration, Interfaces, Interoperability, Meaningful Use