Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

This month’s New England HIMSS event filled our usual meeting place, Papa Razzi in Wellesley, MA to near capacity.  While the events typically start off with networking and socializing, it was difficult to walk around the room because of the crowd on hand.  The draw? Mac McMillan, the National Chair of HIMSS Privacy and Security Task Force and Chuck Podesta, the CIO of Fletcher Allen Healthcare were here to talk about a real life security incident that threatened the integrity of the organization’s data, and how they responded.

First, some statistics:  Fletcher Allen Healthcare is Vermont’s academic and university medical center located in Burlington, VT (also home to offices of Galen Healthcare Solutions as well as Allscripts). There are 562 beds and in 2010 there were 50,419 outpatient admissions, and 60,356 ED visits (FletcherAllen.Org).  Podesta currently runs a staff of about 150 people that support 10,000 end users on 6,000 work stations.

In the evening of March 29^th, end users of Fletcher Allens’ system were infected with a virus.  Six users, who were physicians, clicked links in emails purported to be delivery tracking updates.  Instantly the system was infected with a variant of the virus known as ‘PinkSlipBot’, for which there was no virus definition available.

Podesta’s team reacted immediately and was able to ‘secure the perimeter’, including blocking outbound traffic, and isolating the effected networks.  Luckily, only a handful of packets had escaped the network and they were actually analyzed and found to have not contained any protected health information, or PHI.  The virus was very aggressive.  It was programed to obtain local admin rights, shut down the virus scanner that was installed (McAfee), install a rootkit which hid itself from detection, and lastly, install a keystroke logger. Podesta and his team were able to learn off of this after analysis of the temp files left behind by the virus. Before it was brought entirely under control and mitigated, the virus had infected over one thousand hosts!

“The whole org is much more focused on [security] as a result of the virus”, Podesta told the NEHIMSS audience.   At the time of the incident, the team at Fletcher Allen consisted of less than ten people.  In the 48+ non-stop hours spent protecting and cleaning up their networks, the initiative grew to include about sixty people, which spent ninety minutes on each infected host, and ultimately cost the organization “in the 6 figures”.

At the conclusion of the presentation the speakers asked the audience (by a show of hands…) if security is a regulatory issue, or a patient safety one.

While no PHI was disclosed, and no patients were harmed, the answer is simple: it’s both.

While the EHR remained functional and connected throughout the ordeal, portions Fletcher Allen’s network were down for periods of time.  Galen Healthcare Solutions offers VitalCenter, a downtime solution for the Allscripts Enterprise EHR – no matter why the EHR is unavailble.  For more information visit vitalcenter.galenhealthcare.com.

If you missed it, check out my PHI related blog from last month here.

 

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. 

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

Galen Certified – The New Standard for Allscripts Enterprise™ Expertise!

Our consultants have always been the experts when it comes to the Allscripts Enterprise EHR™ application and now they have the certification to prove it! We are proud to announce the Galen Certified-Enterprise EHR Application Specialist training and certification program. This week marks the completion of Galen’s second group of employees who have taken part in our intensive seven week training that concludes with both a written and verbal examination.

The training, which is designed and performed by our experts, consists of an in depth review of all the Enterprise Certified Workflows and build methodologies with an added emphasis on the clinical relevance of each. Much like that of the Configuration Workbook, we step through Base, Rx, Charge, Order/Result, Note, CareGuides, Dictate, Transcribe and Scan. Along with the module specifics, we provide an entire System Administration review with the latest 11.2 Enhancements and configuration techniques.

During the training each student is provided with their own virtual 11.2 Enterprise environment so they might build, test, and configure without the concern of being in a LIVE environment or configuring over another user. As part of the testing process each student is required to build out a mock client environment from scratch. They are given mock client build specifications that begin with the organization set up and build of users, right down to the assignment of all Task List and Worklist views. They participate in “real-life” patient care/documentation scenarios to ensure that they are prepared to support the actual day to day needs of the end user without hesitation or delay.

We began the training and certification with newly hired employees and then expanded it to include verifying the overall level of understanding of the Enterprise product by including our Senior Consultants. We are proud to announce that as of today 15 employees already hold the distinction of being Galen Certified Enterprise EHR Application Specialist, with 7 more preparing to test in the next 2 weeks.

We are currently working to complete the training and certification for all the consultants on our Service Team. As well, the future will include Advanced Certifications in areas of V11 Note, Order/Results, Charge, CareGuides, and System Administration.

Please join me in congratulating the following employees:

Michael Dale, Associate Consultant

Michael joined Galen in April 2011 as an Associate Consultant. He attended the initial class for Galen’s Certification program. He was the first employee to officially become “Galen Certified – Enterprise EHR Application Specialist”. In his six months in this industry, he has grown very familiar with Allscripts Enterprise EHR™ and has become a frequent contributor to the Galen Blog. In the coming months, he plans to contribute to the Galen Public Webcast series.

Michael graduated from Iowa State University in 2005 with a Bachelor’s Degree in Management. His background includes analytical experience in the Healthcare industry and a variety of leadership positions.

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Zia Rahman, RHIA, Associate Consultant

Zia works primarily from the Chicago office and focuses on Allscripts Enterprise EHR™ implementations. He is a recent graduate from the University of Illinois with a Bachelor of Science in Health Information Management and is also RHIA certified. Most recently he has been assisting a large client in the Midwest as their dedicated resource to help the implementation go as smoothly as possible. Zia is always dedicated to ensuring the project is a success.

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Christy Erickson, Consultant

Christy joined Galen in March of 2011 as a Consultant serving clients in either Project Manager or Implementation Consultant roles specializing in clinical workflows and v11 Note. Before joining Galen, Christy was Operations Manager for Abraxas Medical Solutions (now Merge Health) responsible for implementations, support, technical services, and client education. Prior to that, Christy spent three years at Allscripts in both project management and consultant roles where she was named the 2008 Allscripts Service Employee of the Year and promoted to Manager, Professional Services. Before entering the health IT industry, Christy worked in nursing as a nurse and nurse practitioner with experience in outpatient, hospital, and hospice, including several years in Spain as an ICU/OR nurse where she became fluent in Spanish. Christy earned both her Bachelor of Science and Master of Science in Nursing from Salisbury University in Maryland and currently lives in Southern California.

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David Burkhead, Managing Consultant

David joined Galen in March 2010 as a Consultant and recently transitioned from Senior Consultant to Managing Consultant. In his 6 years working with Allscripts Enterprise EHR™, his project experience has included Project Management, Implementation Consulting, Conversion Analyst, and Interface Analyst roles. In his recent experience with Galen, he has been involved with an Enterprise EHR™ READY deployment, external webcasts, and an occasional contributor to the Galen blog. David graduated from The University of Vermont in 2005 with a Bachelor’s Degree in Business Administration along with a concentration in Management of Information Systems.

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Cecil Hunter, Senior Consultant

Cecil has been an integral part of the Galen team since April 2008. He has more than 11 years of experience in the health care Industry and 6 years of experience with Allscripts Enterprise™ EHR deployment. Cecil has most recently worked on a deployment of Enterprise EHR™ Version 11 modules for a large comprehensive network of affiliated physicians in Columbia, South Carolina. Cecil is certified in Allscripts Enterprise EHR™ Version 11 System Administration, as well as, Allscripts Enterprise EHR™ Version 11 Upgrades. Prior to joining Galen, Cecil served as an Allscripts Super User at a major University Healthcare Group in South Florida.

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Steve Cotton, Managing Consultant

Steve has been with Galen Healthcare Solutions since January 2010 and has recently transitioned from Senior Consultant to Managing Consultant. Following his years of experience at Allscripts Healthcare Solutions as a Senior Implementation Consultant and the Lead Internal Educator, he has continued to exhibit his expertise in project management, implementations, and education. In his recent Galen experience, he has contributed to the Galen external webcasts, assisted multiple clients with the Order Synchronization process, and serves as the primary implementation resource for Galen’s business continuity solution, VitalCenter. Steve has a Bachelor’s degree in Health Information Management and a Master’s degree in Health Informatics; his educational background has provided him with a strong understanding of the Healthcare Industry.

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Carl Fulton, Lead Consultant

Carl has more than eight years experience with healthcare information systems, specializing in Project Management and Implementation Consulting for Allscripts Enterprise EHR™. He has led implementation efforts for a range of clients, affecting thousands of providers, using all modules within Enterprise EHR™. In addition to his background in healthcare information systems, Carl has a Masters Degree in Organizational Leadership from Gonzaga University and Bachelors Degree in Management Information Systems from Washington State University.

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Cyn Gerson, Senior Consultant

With over ten years of health information systems experience, Cyn has played an integral role in many client projects; including implementation & deployment of all Allscripts Enterprise EHR™ modules, for many healthcare systems around the country. Most recently Cyn took a lead role with a major multi-specialty organization to get them live on their latest implementation phase, which included multiple Order/Result interfaces, Charge and v11 Note.

Cyn has demonstrated her skills in project management, workflow analysis, application build, interface testing and end-user training & support. She has a strong work ethic combined with a commitment to excellence in all projects undertaken, and continuously strives to cultivate positive relationships with her clients while providing objective guidance in accomplishing their goals.

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Tony Yelacic, Senior Consultant

Tony Yelacic has been with Galen Healthcare Solutions since 2007. He came to Galen with 30 years of healthcare experience across clinical, operational, and information systems areas. His unique blend of skills has provided many opportunities for the Galen community.

 

 

 

 

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Karla Koertner, Consultant

Karla Koertner is a software implementation professional with more than 11 years in healthcare. She is experienced with both acute and ambulatory care software systems and has functioned as a Project Manager, Subject Matter Expert, and Implementation Consultant on several large scale Allscripts installs. Karla resides in Charlotte, NC and looks forward to a long career with Galen Healthcare Solutions.

 

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Matt Woodside, Managing Consultant

Matt has been involved with the design, build and implementation of clinical software for over 10 years, including extensive experience with clinical application testing and evaluating end-user readiness. Most recently, he has been working with Senior Implementation staff, Clinical Analysts and Hospital Management to roll-out Allscripts Enterprise EHR™ to the first Beta sites in the network at one of the largest Allscripts clients in the Northeast. Matt was also involved with leading the client team through their recent Allscripts Enterprise EHR™ version11.2 upgrade. Matt is looking forward to continuing to apply his knowledge and experience to current and future client needs.

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Steve Stahr, Senior Consultant

Steve joined Galen in April 2008, and has been integral in assisting clients with their EHR projects, both as a Project Manager as well as Implementation Consultant. More recently, Steve became more involved with the Galen Upgrade Team, assisting with the increased demand of upgrading clients trying to achieve Meaningful Use and report from the Stimulus Set. His interest in the Orders and Results modules of Allscripts Enterprise EHR™ has given him the opportunity to assist many different clients with navigating this significant and strategic process. Steve has also been very involved with hosting webcasts through Galen’s Free Webcast Series, and conducted on site training with clients, as well.

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Will Ditton, Senior Consultant

With more than 10 years experience in Healthcare IT and working with Allscripts products, Will has had the opportunity to be involved with clients ranging in size from small to large MSO. His experience includes implementing Allscripts Enterprise EHR™ as well as assisting clients with optimization. In addition to his main focus on the Enterprise EHR™ application, Will has experience with Network and System Administration. Will has proven to be a huge asset to Galen’s clients and he looks forward to assisting future clients in achieving their goals.

 

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Litisha Turner, MSN, Clinical Consultant

Litisha has been with Galen as a Clinical Consultant for one and half years. She is a Registered Nurse with a Master’s Degree in Nursing Informatics. Her focus has been on building notes, forms, text templates and flowsheets for various clients including Northwest Community Hospital, Scripps, North Florida Surgeons and University Physician Associates. She has provided remote System Administrator training and end user training to a number of clients, as well as v11.2 Upgrades and work on bidirectional lab interfaces.

 

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Laleen Shah, Associate Consultant

Laleen Shah has been with Galen Healthcare Solutions since May 2011. In her recent experience she has been involved with a large healthcare organization in Iowa, assisting in system build, go live support, and data gathering for upcoming go-live events. She is currently a Galen Certified Enterprise EHR Application Specialist. Laleen graduated from the University of Illinois at Chicago in 2011 with a Bachelors Degree in Health Information Management.

 

 

 

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Tags: Allscripts Consultants, Allscripts Enterprise EHR, Galen Certified - Enterprise EHR Application Specialist

It’s been an exciting quarter for everyone in the Allscripts community as more and more physicians are adopting EHR technology and health systems across the country are positioning themselves for Meaningful Use. As our industry continues to evolve, Galen has recently made some key promotions designed to give our employees additional support needed to provide high-quality services to a growing client base. Their leadership allows our company to stay better connected. Please join us in congratulating the following people on their recent promotions.

Dave Burkhead, Managing Consultant

Dave knows the configuration of the Enterprise EHR application front and back and has worked on the interface and technical side of the application. In addition to this product knowledge, Dave has project management experience and a natural ability to lead. This combination of product knowledge and higher level vision is at the heart of what Galen provides, and it’s what makes Dave such a valuable asset to both his clients and team members. Congratulations to Dave on this well-deserved promotion.

Steve Cotton, Managing Consultant

Steve came to Galen with superior product knowledge and a willingness to do whatever it takes to help his clients, and that has not changed. Steve does all things Enterprise EHR™; trainings, onsite support, orders/results build, interfaces, VitalCenter™ implementations, external Galen webinars, and much more. In addition to his client work, he has been a steady contributor to internal projects and is the true epitome of a team player. In his new role as Managing Consultant, Steve will be able to bring years of consulting and application experience to his team. We congratulate Steve on this well-deserved promotion.

Michael Ficociello, Upgrade Manager

Michael was one of the original upgrade team members who started in 2008 and has made immeasurable contributions to its success in the years since. His work ethic and attention to detail have allowed him to provide superior services to his clients, and his passion for process improvement has allowed the entire upgrade team to stay organized and on point. In his new role of managing the upgrade consultants and upgrade project managers, Michael will continue to provide leadership to the team in addition to his full workload with his own upgrade clients. Congratulations to Michael and thanks for all the hard work.

Troy Forcier, Senior Upgrade Technician

Troy has been upgrading Galen’s client base for the past three years, working with just about everything between V10 and V11. During that time, he has taken on some of our largest clients as well as some of our smallest, and done great work at every stop. In addition to his upgrade work, he has also gone on-site with clients to perform assessments of their Allscripts infrastructure, visited clients to perform Galen’s System Maintenance Training, and hosted educational webcasts.  He has also been a tremendous help in on-boarding some of our newer upgrade resources, allowing Galen to bring top-quality technical services to a growing client base. We congratulate Troy on his promotion to Senior Upgrade Technician.

Carl Fulton, Lead Consultant

Carl has been with Galen since September 2007 and has worked with multiple clients throughout his time with Galen.  The common theme with each is that they keep coming back to Galen for support with their implementations, upgrades, and other projects. He has tremendous product knowledge and combines his great sense of humor with a level of professionalism that makes him a great resource for all clients. In addition to his client-side impact, Carl plays a large role internally for the service team. He is truly an asset to the clients and to Galen. Carl has made the transition from Consultant to Senior Consultant to Lead Consultant in his four years here, and we congratulate him on his newest promotion.

Matt Woodside, Managing Consultant

Matt has been promoted to Managing Consultant and will now take on responsibilities for managing part of the service team in addition to his continued full-time client work. Matt has a combination of extensive product expertise and excellent leadership capabilities. His strong project management skills have helped him provide direction and leadership to one of Galen’s largest clients as they move towards Meaningful Use. Within Galen, he has helped with the recruitment of new employees, ensuring that Galen employees continue to represent the highest standard. Congratulations to Matt on his exciting new role as Managing Consultant.

Tags: Allscripts Consultants, EHR Implementation

Have you ever found yourself asking how the heck does Imagelink work?  How is it possible to click a button in the Allscripts application and view an X-ray?  Have you ever wanted to know how a result closes an order is closed without a Touchworks Order number?  Have you ever heard someone say, did you check the requested performing location dictionary, and not know what they’re saying?  Have you ever wanted to know more about Allscripts result interfaces?

Well you are in luck! The Galen technical services team is proud to host a Free Results Interface Training hosted at it’s brand new office!

Who: Allscripts Interface Analysts

What: Free Result Interface Training

Where:  70 Federal Street, 7th Floor, Boston, MA 02110.

When:  Wednesday, December 14th, 2011 from 9AM-5PM with lunch provided.  There will also be a cocktails and networking hour from 4PM-5PM with beer, wine and light snacks.

Why: Learn about more of the intimate details, nuances, and best-practices surrounding Allscripts result interfaces

Agenda:

• Imagelink
• Reconciliation w/ and w/o eletronic order interface
• Common errors
• Requisitions
• Requested Performing Location
• Auto synching
• Much More!

Please contact us if there is a topic you would like to learn more about that isn’t in the list above.

Travel:  If you are driving into the city, there are parking garages nearby. The cheapest and most convenient is the Winthrop Square Parking Garage at $20/day.  If you are coming in from out of town, there are many hotels in the area.  Also note that we will have wireless internet and workstations with a hardwired internet connection available for those who need it.

Space is limited – Register Today! If you can’t make the training, it’s ok!  Galen offers free webcasts about every two weeks.

Tags: Allscripts, Allscripts Enterprise EHR, Allscripts Interface, ConnectR, ConnectR Training, Galen Webcast Series, Integration, Interface Training, Interoperability, Results Interface

This past Tuesday, I attended the NEHMISS Monthly Event and Social hosted at the Papa Razzi in Wellesley, MA with one of my colleagues, Patrick Zummo. It provided an invaluable opportunity to network with other healthcare IT professionals as the event had one of its best turnouts in the past two and a half years that we have attended (I would estimate about 65 attendees!) It was great catching up with folks and seeing new faces. The networking opportunity can’t be underscored enough!

The event featured a presentation on “An Approach to Meaningful Use” by Laura Leinin, Sr. Project Specialist, Clinical Information Systems at Partners Healthcare, and Jennings Aske, J.D., CISSP, CIPP, Chief Information Security Office at Partners Healthcare.

Laura started things off with an overview of the MU legislation to date:

• Original goal of MU legislation was to target full EHR adoption by 2014
• The three phase of EHR: Adoption – MU – Outcomes
• Compuer Sciences Corporation (CSC) estimated that for a hospital with 276 beds, the potential MU payout would be $4.2 million
• The major certifying entities for EHR software is Certified Commmunication for Health Information Technology (CCHIT) and the Drummond Group. The model utilized is a conformance tool where submission of data is required.
• Attestation if currently a manual process – submission of the numerator and denominator.

Jennings followed by addressing security compliance & MU:

• The main components of security compliance include access control, emergency access (“break-glass” capability), auto log-off, and audit log.
• Jennings noted that with the audit report, requirements included capture of userid, patientid, user activity and the ability to sort by time.
• An example of compliance presented was since Partners had a home-grown EHR system (longitudinal medical record – LMR), in order to comply with CCHIT & Drummond certification, the system needed to possess the capability to handle encrypted file import.
• Jennings expressed that Partners needed to exhibit compliance as described above, but in some scenarios (like the encrypted file import described above) they don’t actually intend on using the functionality. This led me to wonder what the percentage of cases were where the EHR needed to comply with security standards, but would never actually use or implement the feature in operational practice.

For the remainder of the presentation, Laura offered some statistics and updates with regard to Partners MU initiative:

• As of Thursday, September 30^th, 114,644 EPs & EHs have registered for attestation.
• As previously noted, attestation for stage 1 is currently a manual process and Laura warned of the high chance that organizations are likely to be audited post-attestation and as such they should have the records and data to back it up.
• She noted that Academic Medical Centers (AMCs) need to be self-certified in that they often have home-grown systems in the inpatient setting and noted that community hospitals often have commercial off the shelf (COTS) systems provided by the leading EMR vendors.
• She provides a project status dashboard each month to stakeholders and executives with more than 125 data points to track each month!
• Laura also mentioned the challenges of qualifying for MU in the presence of the healthcare information system mosaic at Partners that we’ve previously touched on in our blog in that of the different organizations that are affiliated with Partners (Brigham and Women’s Hospital, Massachusetts General Hospital), there are different vendor systems for ED (Electronic Discharge) systems, PM (Practice Management) systems, etc.
• In some cases, to qualify for meaningful use, workflows had to be adapted. One example was the handout of clinical summaries to patients.

Several great questions were posed by the audience including the following

• Q: Is standardization of vocabularies at Partners being handled by IT or the clinical staff? A: IT staff
• Q: What’s the headcount needed at Partners for the MU initiative? A: About 50 people across hospitals and LMR teams
• Q: How is Partners handling the case where smoking status is not captured discretely, but rather exists in a note? A: The homegrown LMR at Partners currently captures smoking status discretely. However, there are NLP (Natural Language Processing) solutions (Autonomy, Nuance come to mind) to post-process the non-discrete data for those applications which do not store it discretely. We have touched on data-mining non-discrete data in a previous blog post.
• Q: What happens if an organization decides to switch an EHR going forward? How is certification and MU qualification handled? A: No presenter or audience member had experience in switching organizations, but as we’ve witnessed with EHR vendor consolidation and an explosion of acquisitions requiring data conversions, this is likely to be a hot topic going forward.

Tags: Allscripts, Allscripts Data Mining, CCHIT Certification, Custom Reports, Drummond Group Certification, HIMSS Meaningful Use, Longitudinal Medical Record, Meaningful Use, Meaningful Use Security Compliance, NEHIMSS, New England HIMSS, Partners Healthcare Meaninful Use

This week, the world lost one of the most innovative people of our time. Steve Jobs, co-founder of Apple Computer, passed away leaving behind quite the legacy. I feel obligated to honor Steve Jobs this week and reflect on how he affected technology in health care.

It is amazing to reflect upon the history of Apple computers. It seems not too long ago, I was learning how to use a Macintosh computer playing Number Crunchers and Oregon Trail in Elementary school. Back then, the idea of a computer with a mouse was relatively new technology! Twenty years later, Jobs’ vision has evolved technology well beyond that grey box, keyboard, and mouse.

Take this timeline for example:

• May 1984 – Macintosh was released using a graphical user interface controlled by a mouse (courtesy of Xerox technology)
• April 2010 – Apple releases the first iPhone, optimizing a user interface that would pave the way to the iPad and an extensive library of applications that remains the most popular OS to developers today.

What an advancement in technology in twenty six years! So while the only Apple product I own is an iPod, I remain deeply amazed at the technology Apple offers and how much its technology touches our lives. Apple products remains as probably the most popular choice for mobile computing in the United States.

Business Insider published an article in July 2010 titled “10 Ways The iPad is Changing Healthcare”.  While it’s a quick click through the list, you certainly get a feel for the opportunities the iPad has presented to healthcare. Examples included “Going Green”, cost savings, and information consolidation. All this was made possible with the vision of Steve Jobs.

Did you know?:

According to Wikipedia on Steve Jobs:  “Jobs is listed as either primary inventor or co-inventor in 338 US patents or patent applications related to a range of technologies from actual computer and portable devices to user interfaces (including touch-based), speakers, keyboards, power adapters, staircases, clasps, sleeves, lanyards and packages.”

Being in the Electronic Healthcare Record industry, I want to share a couple examples that resulted from Jobs’ technology.

Thank you to the iOS software and the work by developers at Allscripts^TM, there are two applications that Allscripts^TM offers that can be utilized using an iPad or iPhone.

ePrescribe:

This application allows providers to use their iPhone/iTouch to view patients from their Practice Management System.

Features:

• Summary page that identifies and presented problems, allergies, unprocessed medications, and any active medications
• Allows providers to write prescriptions using an excellent, user-friendly design
• Displays formulary indicators and DUR
• Can submit Rx’s direct to Pharmacy, Send to Mail order, and send to a printer

For more information on Allscripts^TM ePrescribe, visit their webpage to learn more.

Remote EHR:

This is another excellent application that is utilized by healthcare facilities using the iOS software that allows providers to remotely control their AllscriptsTM Electronic Health record from any location.

Features:

• Provides real-time access to patient summary information
• Includes ePrescribing to the patient’s pharmacy
• Integration with Charge capturing and attaching diagnosis codes to scripts
• Compatible with Allscripts^TM Enterprise EHR v11 (among other Allscripts products!)

For more information on Allscripts^TM, visit their webpage to learn more. Additionally, Galen Healthcare Solutions offers a Wiki page with more information regarding Remote EHR.

So, thank you Steve Jobs for making such applications possible. Remote EHR and ePrescribe are two examples of the results of Jobs’ achievements and have allowed for better patient care.

Share your thoughts! Give us your feedback on how you’ve used this technology in healthcare and how you see its benefits or contributions.

As always, do not hesitate to contact Galen Healthcare Solutions for more information.  Galen is a Preferred Platinum Partner of Allscripts^TM .

Tags: Allscripts, Allscripts Enterprise EHR, EHR, Enterprise EHR, ePrescribe, Healthcare IT, iOS, Remote EHR, Steve Jobs, v11