Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

It’s no secret that we all have busy lives.  As professionals and individuals, we are all important pieces of the larger puzzle of the healthcare community. As partners working towards a common goal, we continually collaborate and contribute to the bigger picture of an ever-improving healthcare system.

I’ll be the first to admit that it can be easy sometimes to get caught up in the day-to-day tediousness of all the little details that require my attention inseeing a myriad of projects through to their fruition. That being said, I think it is important to not lose sight of the bigger picture and to fuel the fire of our motivation by taking a step back from time to time.

Recently, someone shared an old story with me about a man who walks by a construction site and sees workers pushing wheelbarrows; each filled with an enormous stone.

The man asks one of the workers what they’re doing.

“What does it look like?” he says with a sneer.”Hauling rocks.”

Unsatisfied with that answer, the passerby asks another construction worker the same question.

The workman doesn’t bother looking up. “We’re putting up a wall.”

Frustrated, the man tries one last time. “I say there,” he asks the next worker, “can you tell me what you are doing here?”

The worker puts down his wheelbarrow, wipes his forehead and says with a broad smile, “We’re building a cathedral.”

Here are three workers, all doing the same job. One is hauling rocks. One is putting up a wall. One is building a cathedral.

This story says a lot about the attitude that each of us brings to our lives… or could if we were willing to change our perspective. At Galen, we pride ourselves on our attitude and I think this story speaks true to one of the main motivators of our collective outlook.

Each of us plays a vital role in our respective realms as we focus on ‘hauling our rocks’ to meet this deadline or solve that problem. As we move forward, we slowly but surely ‘build walls’ and accomplish individual and organizational objectives.

But the real objective of our efforts, whether we realize it or not, is actually helping to achieve a better healthcare system in this country, one small step at a time. In our own unique way, and with each accomplishment, we help to realize this collective dream.

Attitude truly is everything. Yes, it may sound like a cliché to some, but this simple statement speaks volumes towards one fundamental change of perspective we can make, which in turn can make an overwhelming impact on the level of happiness and enhance the quality of our day-to-day lives.

The choice is yours. You can haul rocks. You can put up walls. Or you can build a cathedral.

Does your practice utilize the Finish Note task in Allscripts Enterprise EHR^TM? 

If you answered yes, then this blog is for you.

In this article, I wanted to show you two possible outcomes when working in your  v11 Note. You will notice that there are two similar workflows to add and commit clinical data in the note that will impact how a Finish Note task appears in a user’s task list.

While you will find that these two workflows are scaled down to be very basic and generic, I wanted to limit them to clearly demonstrate the difference between the two.

Workflow #1: Committing data while saving and closing the v11 note

In this workflow, we assume that the user already has the patient in context at the clinical desktop.

The basic steps of this workflow are as follows:

1. Create a new v11 note
2. Add a new clinical item
• For example: add vitals to the patient chart
3. Select “Save and Close” in the Note window
4. Select “Save and Continue” on the Encounter Summary
5. Navigate to the Task List and select the Current Patient – All task view

Here you can see that the outcome is:

- One Active Finish Note task

So in this case, using the Current Patient – All or Current Patient – Active task views, you will see that just one Finish Note task has been created in an active status.  The task indicates that the note has been created and saved.  Keep in mind, at this point, that the commit action occurred while the user selected Save and Close in the Note. In this workflow, the system only reviewed the data once.

Workflow #2: Committing data prior to saving and closing the v11 note

As we did in the first workflow, here we assume that the user already has the patient in context at the clinical desktop.

The basic steps of this workflow are as follows:

1. Create a new v11 note
2. Add a new clinical item
• For example: add vitals to the patient chart
3. Click the Commit button
4. Select “Save and Continue” on the Encounter Summary
5. Select “Save and Close” in the Note window
6. Navigate to the Task List and select the Current Patient – All task view

Here you can see that the outcome is:

- A Complete Finish Note task and an Active Sign-Note task

If you use a task view that simply shows Current Patient – Active, you would not typically see the Finish Note task in this instance, but instead the Sign-Note task.  This means the note has not been signed and might not be the task you expect to receive if you seek the Finish Note task.

While a Finish Note task has been generated and marked as Complete, there may yet be information to add to the note.  The logic behind this workflow is that the second action of “Save and Close” is the second review after having hit “Commit”, and therefore results in the outcome we see here.  In this case, the system has reviewed the data twice, and the Finish Note task in regards to this note is completed and the active Sign Note task is automatically generated.

My advice in this situation is to follow Workflow #1 when working in a v11 Note. If users are creating a note and adding clinical data, but need a provider or second user to receive a Finish Note task and add additional items to the note; use the first workflow.   This way, the Finish Note task will be assigned and visible to the correct person, and users will be trained in such a way that ensures the success of this workflow.

Please don’t hesitate to leave your feedback below or Contact Galen Healthcare Solutions should you have further questions!

Tags: Allscripts, Allscripts Enterprise EHR, EHR, Enterprise EHR, Galen Webcast Series, Tasks, TouchWorks, v11, v11 Note

CMS released a couple of updates last month regarding Meaningful Use and the EHR incentive program. I wanted to pass this information along to our readers.

In their December 7 update, CMS indicated that “HHS announced its intention to delay the start of Stage 2 meaningful use  for the Medicare and Medicaid EHR Incentive Programs for a period of one year for those first attesting to meaningful use in 2011”.  The reason as such, according to them, is that the current schedule for compliance to Stage 2 could be a challenge for those that attested in 2011. The decision also was in consideration for vendors and practices.

 The CMS update identified some benefits from the proposal:

• The delay could provide vendors more time to develop their certified technologies for Stage 2
• The delay could also provide providers more time to implement the new software to meet Stage 2 requirements
• Expectations remain current so that providers attesting in either 2011 or 2012 begin Stage 2 in 2014
• And while 2011 has passed, CMS believed this idea would provide added incentive for providers to attest in 2011.

While I am sure there is a group of people out there that is ambitious enough to keep pace for this process, I am certain that we all can stand to benefit from the proposed delay.  The benefits from the added amount of time for both the vendors and practices/providers seem more appealing, in my opinion.

Back on December 1, CMS also announced a new tool to help Eligible Professionals (EPs) through the phases of Meaningful Use.  This tool is an eighty-five (85) page PDF file, dubbed as a “Beginner’s Guide”. This file provides a thorough, interactive walkthrough of Meaningful Use.

Among the items of information provided are:

• EHR Incentive Program basics
• How to participate (determining eligibility and registration)
• Meaningful use and choosing measures
• Attestation
• Helpful resources on the Medicare and Medicaid EHR Incentive Programs

Lastly, they also provided a link to their Educational Materials page for the EHR Incentive Program. This link offers an extensive array of files and tools regarding the EHR Incentive Program.  This is definitely a link to bookmark, as well as the guide previously mentioned.

If you haven’t already done so, visit the CMS EHR Incentive Programs webpage and register to receive their email notifications. 

Contact Galen Healthcare Solutions for any additional questions regarding Meaningful Use and Allscripts Enterprise^TM EHR.

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

In the professional world, most of us spend a varying amount of time on conference calls. This can be said of folks both in an office or remote location.  For those that can remember, meetings mainly use to be face-to-face in a meeting room. There was not a dial in number or participant code. People joined around a table or in an audience. Telecommuting was very limited not too long ago.

Technology has certainly driven a shift in how we do business now. More and more people in the workforce perform their jobs remotely. Meetings, for the most part, rely upon a toll-free number and the comforts of your desk at the office or at home. Being a remote employee myself, I wanted to contribute this week with some tips that I have learned regarding conference calls.

 Scheduling

 -          Software

• Be aware of what scheduling program others use. One example is Microsoft Outlook. External recipients may not have the same program and therefore you increase your risk of someone not receiving important invite information

-          Time Zones

• It is important to know if there are differences in the time zones that attendees currently reside. This is critical for arranging the meeting time.

-          Length

• Try to keep meetings to an appropriate length. Estimate a realistic amount of time to set aside. This is beneficial to stay efficient and make the best of everyone’s schedule.

-          Coordinate

• Actively coordinate times between standing meetings both for yourself, and attendees.  Keep in mind that it may not always be possible to accommodate 100% of the requested attendees. It is however good practice to accommodate most attendees, especially essential attendees.

-          Prepare

• For more formal meetings, or meetings that have structured purpose, create an agenda both for yourself as a host and attendees.
• An agenda helps hosts prepare for the meeting, as well as attendees prepare for relevant talking points as necessary. Share the agenda if necessary

-          Arrival

• Try to join the call at least three (3) to five (5) minutes prior to the call start time. This will allow the host to begin the meeting on time. The exception to this would be when calls are scheduled back to back.

During the call

-          Noise

• As an attendee, it is absolutely critical to not cause background noise during a call. My main rule: If I’m not talking, I’m on mute.
• Some conferencing services allow the host to mute all attendees. That feature is excellent for webinars, as this is often used during the Galen Webcast Series.
• Less formal calls don’t require this kind of mind set; therefore it is best to gauge the call to determine your actions.

-          Start

• Meetings should begin on time as best as possible. Starting a meeting on time respects the efficiency of everyone’s schedule and optimizes the time allotted to tackle an agenda. Again, a barrier to accomplishing this occurs when meetings are frequently scheduled back-to-back.

-          Stick to the point

• Meeting hosts should manage the call effectively. Stick to agenda items.
• Prevent yourself and attendees to digress or side track from the topics at hand.  Meetings will often end too early or extend past a planned time if participants speak “off topic” or ineffectively discuss agenda items.

-          Listen

• Active participation in a call is expected of attendees.
• Try at every extent to not multitask during a call. You never know when the conversation might turn to you. Calls are not efficient when a participant is not paying attention; additionally the participant’s image is reflected poorly.
• Be mindful of any language barriers. Diversity is an excellent aspect of the globalization business operations. Respect and pay closer attention to those you might not easily understand, both in dialect and grammar.

-          Parking Lot

• Keep a “parking lot” list during the call for action items. This is something best done by the host or delegated to an attendee to maintain and share after the call.
• Other participants should keep their own list as well, in case of personal action items. This way, you aren’t waiting for the list from someone else for your items.

-          Notes/Minutes

• As similar to the parking lot list, someone should actively take minutes for more formal calls to share with the meeting participants. This helps solidify any items mentioned in the call and records for future reference.
• For formal and non-formal calls, it is very effective to take notes for personal use for future reference.

-          End

• Hosts and attendees that manage the time effectively often may finish early and return some time to the day.
• Be aware of the time relative to the scheduled end time. Once it draws about five (5) minutes before the scheduled end time, determine the best next course of action. The action either could be one of three possibilities: Continue with all or a portion of the participants, reschedule the call to proceed with the conversation, or end the call as it stands. The latter being the least likely course of action.
• If the meeting needs to be rescheduled, be mindful of the scheduling tips mentioned previously. Scheduling a new call can be done after the current call.
• Clearly express any expectations prior to adjourning the call.
• Thank everyone for their time!

 After the call

-          Wrap up

• Send out any new meeting invites as soon as the prior call has ended.
• If any minutes or notes were taken, be sure to share the documentation with the attendees (as necessary) as soon as possible.
• Act upon any action items either for the parking lot list or assigned items as necessary. The sooner something is completed, the sooner it is off the list!
• For more formal calls and as a host, be sure to send a follow up thank you note to participants for their time.

-          Feedback

• For webcasts or formal calls, request feedback for continuous improvement.

Some of these tips do blend into the topic of time management. I think time management becomes more crucial before, during, and after conference calls. As we are more remote these days, more effort is needed to close any loops between meeting attendees. Some meetings are simpler and require less attention, whereas some meetings are more formal and require great effort.

The tips I shared are simply from personal experience. I know people with far greater experience have dedicated books to this topic. I thought some might benefit from a brief article regarding conference calls and some friendly advice.

I am absolutely positive there are people that agree, disagree, and have their own perspective or tips to add!  Please, share your thoughts, feedback, stories, and tips in terms of conference calls! I look forward to seeing this discussion continue and what others might have to contribute to this matter.

Tags: conference calls, Galen Webcast Series, Training

 The Allscripts Enterprise EHR is a wonderful example of the healthcare industry utilizing technology to improve the overall quality of the care provided to its patients, who are ultimately its customers.  While many arguments can be made in favor of the electronic health record, perhaps none is more prevalent than the ability to have a patient’s chart only a few clicks away.  The EHR stores an incredible amount of information about patients – from general information that helps identify, such as name and mailing address, to more personal and medically relevant information such as diagnoses and allergies. Let us examine the Allscripts Enterprise EHR, and the various resources that help it work, in the context of Protected Health Information security and privacy.

HIPAA, the Health Insurance Portability and Accountability Act of 1996, is legislation that protects health insurance coverage when workers change or lose their jobs, while also limiting restriction of benefits for preexisting conditions.  It also created several programs to control fraud and abuse within the healthcare industry.  These initiatives are contemplated by HIPAA’s Administrative Simplification Rules, two of which are summarized below:

-        The Privacy Rule

“The Privacy Rule standards address the use and disclosure of individuals’ health information—called “protected health information” by organizations subject to the Privacy Rule — called “covered entities,” as well as standards for individuals’ privacy rights to understand and control how their health information is used. Within HHS, the Office for Civil Rights (“OCR”) has responsibility for implementing and enforcing the Privacy Rule with respect to voluntary compliance activities and civil money penalties.”  (www.hhs.gov/ocr/privacy/hipaa)

-        The Security Rule

“The Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) establish a national set of security standards for protecting certain health information that is held or transferred in electronic form. The Security Rule operationalizes the protections contained in the Privacy Rule by addressing the technical and non-technical safeguards that organizations called “covered entities” must put in place to secure individuals’ “electronic protected health information” (e-PHI). Within HHS, the Office for Civil Rights (OCR) has responsibility for enforcing the Privacy and Security Rules with voluntary compliance activities and civil money penalties.” (www.hhs.gov/ocr/privacy/hipaa)

Protected Health Information (PHI) is generally defined as follows:

“ Any information in the medical record or designated record set that can be used to identify an individual and that was created, used, or disclosed in the course of providing a health care service such as diagnosis or treatment.”

ePHI, or electronic PHI is described the same way, except it refers to information only in the electronic form.  If you’re using Allscripts Enterprise EHR to look at a patient’s chart on a computer screen, smartphone, iPad, etc., it’s considered ePHI, but if you utilize the application’s print function and then are physically holding a piece of paper in your hand, it’s PHI.  PHI encompasses ePHI and the differentiation only serves to indicate whether or not the information was in electronic form.

HIPAA specifically lists 18 types of information that qualify as PHI.  That list can be found here.

Where do we find PHI within an Allscripts Enterprise EHR implementation?

There are three major ways to encounter PHI within Allscripts:

-        Allscripts Enterprise EHR – the application itself.

-        Works database – the back end database that houses most information filed into and out of the EHR.

-        ConnectR interface engine – this software processes messages, primarily in the HL7 format, to get information in and out of the EHR.

In the screenshot below we see the Clinical Desktop for patient Kelly Test within the EHR. In this single screenshot we see pertinent information in the patient banner that is used to uniquely identify Kelly Test – her first and last name, date of birth, and phone number.  We also see a current health problem of Emphysema, laboratory orders and results, and the fact that she is allergic to Morphine/Morphine Derivatives. All of this is Protected Health Information.

In the next example we’ll look at the Works database, the SQL Server database that houses most of the data found in the EHR.

The SQL in the example queries several tables within the database, including the Person table and the Problem table.  Several other tables and specific columns are integrated into the query; the result of which produces a listing of all of the patients that have electronic health records within this (test) hospital or clinic, along with the corresponding problems and specific ICD-9 codes for those patients.  This query illustrates the nature of the information inside the Works database and emphasizes the PHI it contains as well.

Lastly, let’s examine an HL7 message being used to communicate a laboratory result for Kelly Test.

Most HL7 messages will contain a PID (Patient Identification) segment.  This message segment alone is full of protected health information, as it is designed to communicate a patient’s full name, date of birth, address, phone number, and MRN, among other types of information.  From this single message we learn that there is a patient named Kelly Test, born on January 1, 1981, currently living at 101 Tremont St. in Boston, MA.  Also contained in this example HL7 message is a DG1 segment, which contains information pertinent to Kelly’s diagnosis.  In this specific example we find the value ‘1540’ in DG1-3.  The value ‘1540’ is an ICD-9 code, so this HL7 message tells us that Kelly Test has been diagnosed with a type of cancerous tumor.

The Allscripts EHR and the components of its implementation, such as the Works database and interface engine, store, utilize, and make available an incredible amount of information. Much of this data is Protected Health Information (PHI) and should be secured and protected in accordance with HIPAA and other legislation such as the HITECH Act.  We want you to be aware of the most common ways to access PHI while using Allscripts Enterprise EHR, and encourage you to contact us with any questions or concerns.

Tags: Allscripts Enterprise EHR, ConnectR, HIPAA, HITECH, PHI, Privacy, Protected Health Information, Security, Works DB

The New England Chapter of HIMSS had their Monthly Event and Social last week at Papa Razzi in Wellesley, MA.  There was a great turn out, including many first time attendees.  The topic of this month’s meeting was ICD-10.  The presenters provided a great overview of ICD-10, how it compares to ICD-9, as well as identified some of the most common and significant concerns about the historic change.

• Currently, there is a CMS mandate to be compliant with ICD-10 by 10/01/2013.
• The United States is the last industrialized nation to adopt ICD-10.  Some countries have been utilizing ICD-10 for years and are now looking down the road at ICD-11.

ICD-9 is approximately 30 years old and is running out of codes. With age, the standard has lost some of its effectiveness.  For example, ICD-9 has no code to describe H1N1 (Swine Flu), an outbreak that effected tens of millions of Americans over the past few years.

One of the perceived benefits of adopting ICD-10 is the level of specificity with which diagnoses and treatments can be described.  There are 14,000 ICD-9 codes, which are composed of 3-5 digit numbers. By comparison, ICD-10 has more than 68,000 codes, which are made up of 7 character alpha-numeric sequences. Transitioning to ICD-10 will mean a five-fold increase in the number of available diagnosis codes. 

 An example referenced during the presentation concerned an ‘open wound on finger’. Using ICD-9 there are three codes available to describe that diagnosis.  Under ICD-10 there are about 400 codes that could apply.  Again, that is directly related to the level of specificity used to describe the wound, combined with putting it into an historical context.  For example, ICD-10 can be used to specify the finger (ie ‘left ring finger’), whether or not the nail was damaged, and whether the diagnosis is being made as part of an initial or subsequent encounter. Below is a diagram from the General Equivalence Mapping (GEM) user guide, published by CMS. 

Note that the same ICD-9 code is used for all four scenarios.

The participants in the event’s panel discussion provided some interesting insight regarding how their respective organizations are working to prepare, train, and ultimately implement ICD-10.  Two common themes discussed by several presenters were that importance of both senior management and physician ‘buy-in’, as well working with the Massachusetts Health Data Consortium to help ease into the transition with providers.  In one example, provided by Lahey Clinic, coders provide feedback to doctors after audits of their computer assisted coding have been reviewed.

Ultimately, physician acceptance and adoption will mostly likely be correlated to policy of CMS to withhold Medicare and Medicaid payments from doctors that are not using ICD-10.

 In the days following the November NEHIMSS event, the American Medical Association (AMA) announced its intentions to stop the implementation of ICD-10:

“RESOLVED, That our American Medical Association vigorously work to stop the implementation of ICD-10 and to reduce its unnecessary and significant burdens on the practice of medicine (Directive to Take Action); and be it further”

“RESOLVED, That our AMA do everything possible to let the physicians of America know that our AMA is fighting to repeal the onerous ICD-10 requirements on their behalf. (Directive to Take Action); and be it further”

“RESOLVED, That our American Medical Association work with other national and state medical and informatics associations to assess an appropriate replacement for ICD-9. (Directive to Take Action)”

 Galen Healthcare Solutions offers project management, implementation, and training solutions. Contact us to find out how Galen might assist your ICD-10 transition.

Tags: Galen Healthcare, HIMSS, ICD-10, ICD-9, NEHIMSS

The last few months at Galen have been wildly successful. We have continued to grow with the industry, and in the midst of this growth, several of our employees have stepped up and received important promotions. We are excited to recognize those people here.

Justin Campbell, Director, Integrations

Incredibly passionate about his work, Justin Campbell’s clients have raved about him and the work he does. Rarely does a week go by that we do not receive kudos for his work. He is consistently working on the Galen Wiki, the Blog, and now the Interface Forums, sharing what he’s learned and promoting the Galen brand.  Despite his already expert-level product and industry knowledge, he continues to eagerly learn more and share that knowledge with others in the community. His contributions to the company cannot be overstated.

Justin’s new position will allow him to continue the work that he has already been doing for quite some time –mentoring the interface/integrations team and developing our integrations business. His expertise in interfaces, conversions, patient summary exchanges, HIE, and UAI will serve him well as he moves forward as Director, Integrations. Undoubtedly he will also continue to contribute to Galen’s success in all the countless other ways he has for a long time.

Congratulations to Justin on a big and well-deserved promotion.

Max Stroud, Senior Upgrade Consultant

As one of Galen’s most experienced Upgrade Consultants, Max has been an integral part of our Upgrade Team since its very beginning. She has great functional knowledge of Allscripts Enterprise EHR™, and her many experiences have allowed her to become one of our true lead Upgrade Consultants. Her passion for learning and teaching has benefitted Galen greatly. Max has been a great teacher and mentor to our newer resources and has been eager to share her knowledge and experience with all members of our company.

That same willingness to share her knowledge has made her invaluable to the many upgrade projects she has been a part of. She brings a great combination of product knowledge, industry experience, and strong interpersonal skills, all of which make her an extremely effective resource and member of our company.

We congratulate Max on her recent promotion and thank her for all the hard work she has put in to earn it!

Michael Ficociello, Senior Upgrade Consultant

Another original member of our upgrade team, Michael Ficociello has been a primary contributor to the success of our upgrade team as a mentor and project manager. His ability to drive projects forward while staying organized and on point has been enormously helpful as we take on more Enterprise EHR™ version 11.2 upgrades. His passion for detail and process improvement allows our entire Upgrade Team to be more effective.  Combined with his strong work ethic, this attention to detail has helped to identify gaps in the upgrade process as well to generate solutions that have since filled those gaps. These contributions to the upgrade process have been invaluable to our clients and have helped  establish Galen as a leading upgrade partner.

We thank Michael for his dedication to our upgrades and to Galen, and for his ability to mentor others on what seems to be an ever changing process. Congratulations on a well deserved promotion!

Steve Stahr, Senior Consultant

Steve Stahr has been a valuable member of the service team while working with a  number of different clients. Among other things, his understanding of orders and results functionality has been valuable not only to his many clients, but also to his peers at Galen. Always eager to lend a hand to a colleague, Steve’s positive attitude and sense of humor have helped Galen become not only a leader in the industry but a fun place to work. Recently Steve has contributed to a number of internal initiatives, including our webcast series, our company trip, as well making the Chicago office a welcoming place for several recent new hires.

Steve is consistently a go-to guy for new projects that spring up, and has always been an outstanding Galen advocate and representative. He takes pride in working for such a great company.

Congratulations to Steve on a well deserved promotion and we look forward to many more years of success!

Tags: Allscripts Consultants

 The Pan Mass Challenge

The Pan Mass Challenge is an annual race across Massachusetts that raises money for cancer research and treatment at Dana-Farber Cancer Institute through its Jimmy Fund.  The race started back in 1980 and raises more money for charity than any other single event in the country.  The PMC donates 100 percent of the money raised directly to the cause.  In 2010, the PMC generated 60 percent of the Jimmy Fund’s annual revenue.  This year, PMC cyclists set a goal of $34 million for Dana-Farber.

Approximately 5,000 cyclists ride in the race each year.  Of the six two-day routes, Zak Fjeldheim chose the longest at 200 miles.  The bike ride will go from Sturbridge to Provincetown, MA.  The event will start with a special event the night of Friday, August 5th in Sturbridge and the race will begin early Saturday and end on Sunday.

To learn more about the Pan Mass Challenge, visit http://www.pmc.org/about.asp?ArticleID=83; or the Dana-Farber Cancer Institute visit, http://www.dana-farber.org/About-Us.aspx.

Susan G. Komen 3-Day For The Cure

Susan G. Komen fought breast cancer with her heart, body and soul. Throughout her diagnosis, treatments, and endless days in the hospital, she spent her time thinking of ways to make life better for other women battling breast cancer instead of worrying about her own situation. That concern for others continued even as Susan neared the end of her fight. Moved by Susan’s compassion for others and committed to making a difference, Nancy G. Brinker promised her sister that she would do everything in her power to end breast cancer forever.

That promise is now Susan G. Komen for the Cure, the global leader of the breast cancer movement, having invested more than $1.9 billion since inception in 1982. As the world’s largest grassroots network of breast cancer survivors and activists, they’re working to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Susan G. Komen Race for the Cure® and the Susan G. Komen 3-Day for the Cure, and generous contributions from their partners, sponsors and fellow supporters, they have become the largest source of nonprofit funds dedicated to the fight against breast cancer in the world. 

This September, Cyn Gerson will again join thousands of women and men to take part of the Susan G. Komen 3-Day for The Cure. This 60-mile journey is held each year to celebrate survivors, honor lives lost, promote breast cancer research and help bring breast cancer care to those who so desperately need it. Eighty-five percent of net proceeds from this event benefits Susan G. Komen for the Cure to fund breast cancer research, education, screening and treatment programs. The remainder of the proceeds goes to The National Philanthropic Trust Breast Cancer Fund, which provides ongoing support to breast cancer initiatives.

To learn more about Susan G. Komen 3-Day for the Cure, visit http://www.the3day.org

When an organization starts out on the long road of implementing an electronic health record the project manager will typically research what steps the organization needs to take to make their EHR project a success.  Learning from others is the most efficient use of resources. So what are the factors that those who have gone before you feel make an EHR project successful?  This is Part II in a series of blog articles on steps to make your EHR project a success.

Part II – Exceptional project management and control

First and foremost is to have an enthusiastic leadership team.  When the leadership team is excited and committed to the project the enthusiasm will be contagious.  That enthusiasm will spread throughout the providers and staff.  Buy-in definitely starts from the top down.  Any end user or recipient of a change implemented can sense when leadership is on the fence about the change.  Therefore demonstrating enthusiasm of the leadership in any and all public forums will be crucial when trying to achieve full buy-in of your organization.  A crucial role of an effective leadership team is to stand behind important decisions made during the life of the project.

 The next item that contributes to exceptional project management and control is holding ongoing meetings with EHR committee & sub-committees. When establishing who your committees should be comprised of make sure you include representation from providers, clinical staff, front desk staff, billing staff, medical records, clinic managers, and key members from you EHR project team.  Sub-committees may need to be formed in order address more specific design decisions needed for certain modules. For example when designing your charge module the sub-committee may be a charge workgroup that consists of billing and coding personnel, managers and those involved on the project team in the build of the charge module.  Holding regularly scheduled meetings provide the avenue for continual and effective communication. An essential component of the meetings is working from an agenda and keeping thorough minutes for tracking purposes.  Being able to have a list of actions items from your meetings is key in keeping the project on target. 

Establish champions of the EHR will help in so many areas of your implementation.  When a provider is struggling with either a workflow or concept of the EHR a champion can step in and provide some much needed assistance and support.  Champions of the EHR are not just your physician champion, your project team, or your leadership team.  These champions are also identified individuals who are supporters of your project.  They are the individuals in the field who hear the day to day struggles that users are experiencing.  When provided an avenue to either assist or report these EHR champions can be extremely instrumental in the continued success of your implementation.

When the project manager is initially beginning the EHR project he or she should set realistic project management processes.  This could include obtaining input from those involved in the build or establishing an effective method of communication to obtain status updates. 

Gather appropriate data and perform necessary research is another significant step in the management your EHR project.  For example when creating flowsheets you will want to gather any and all flowsheets being used in the clinics today.  Or when you are creating your future state workflows not only should you document the current state workflow but your organization should also spend a couple hours following a patient flow.  Simply asking the questions necessary to document the current state workflow is not enough.  As a project team your understanding of the patient flow is a key principle to complete your research. 

 One of the final components of exceptional project management and control is establishing hardware needs and planning accordingly. This would be equivalent to teaching someone how to build a house then not giving them the correct tools.  A provider will find their patient visit difficult to get through documenting if they do not have access to the EHR in the exam rooms.  The success of your EHR implementation is reliant upon this activity taking place long before you begin your implementation.

The final component in exceptional project management and control is to determine staffing needs and do not short change your project. Staffing of your project beyond the project manager includes analysts, who will perform the build activities, a well-trained help desk, trainers, and those who will provide onsite go-live support.  When you feel you have just enough staff members, add a couple more, you will be surprised how long activities take and what all is involved in successfully implementing an EHR.

Over the past year we continued to experience tremendous change as a company, an Allscripts community and as an industry.

As a company we can point to our proficiency with the Allscripts PM and Professional products. Prior to 2010, our Technical Services team had been involved with a handful of interfaces with Allscripts Enterprise PM, primarily the standard interfaces with the Enterprise EHR. In 2010, however, the team took its knowledge of PM interfaces from elementary to expert as demonstrated in the PM Integration article in this newsletter. The team became experts in inbound demographics conversions, customized outbound registration and scheduling interfaces, and began to explore the world of general ledger interfaces. Additionally, the company performed its first conversion of an Allscripts Professional EHR system – splitting a single environment into three as part of a four-party acquisition. Galen also had the fortune of bringing on a handful of experienced Allscripts PM Implementation Professionals in 2010.

It wouldn’t be entirely fair to categorize 2010 as the year of Allscripts PM and Professional at Galen. Our advancements in these areas simply showcase the organization’s willingness to embrace change. Our commitment to learning and, more importantly, sharing what we learn requires us to constantly move into unexplored territory as we strive to add measurable value to our clients. We share our experiences and newfound knowledge within the industry via the Galen Wiki and the Galen Blog. We also see the Allscripts community sharing its knowledge through the Regional User Groups, the AmberSight forums and at ACE each year.

The upcoming year promises to bring even more change to all of us in Healthcare IT. Many groups are aiming to achieve Stage 1 Meaningful Use in 2011. This means an upgrade to Allscripts Enterprise EHR version 11.2. It means capturing new data, like smoking status and language. It means new interfaces, including lab and immunizations. New workflows. New reporting. We all have a lot to do.

At Galen, we began our journey towards Meaningful Use in earnest in 2010 following the release of the Interim Final Rule. Our Meaningful Use Committee began meeting bi-weekly to discuss the rules, their impact and how we can quickly and effectively assist our clients to meet MU in 2011. Galen’s Upgrade Team will be performing nearly 20 upgrades to v11.2 this summer, ensuring the systems are there for our clients to achieve meaningful use in 2011. Additionally our Interface Team has been furiously working the past 12 months on interfaces that aid in achieving Meaningful Use, and will continue to do so over the next two years.

At Galen, we welcome the opportunity of another year working with some of the best health care providers in the nation. We look forward to overcoming the challenges that will come with implementing the software, workflows and procedures necessary to achieve Meaningful Use.
We will stay the course of learning and sharing – with our colleagues, with our existing clients and with the broader Allscripts community.

Mike Dow

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