Archive for the 'Meaningful Use' Category

Top 10 Recent Quotes on Healthcare Interoperability

Much print has been dedicated to interoperability over the past several months. At issue is whether the government (ONC) should attempt to solve healthcare interoperability or continue the course and let the market solve it (or perhaps some in between). We will be discussing this issue with our partners at our annual GPAC event next week in Boston. To prime the discussion – and as part of our interoperability blog series – we present the top 10 recent quotes on the issue:

  1. Interoperability may not have gotten enough attention in the early days of Meaningful Use’s electronic health records (EHR) gold rush, but it’s now taking center stage as healthcare providers, government agencies, vendors, and committees consider how to support the exchange of data easily and securely. It’s very easy to point fingers at folks. People underestimate how challenging this work is,” Sawyer told InformationWeek. “I think the vendors are being cautious before spending lots of research and development money before a standard is more clearly defined.

    -Alison Diana, Information Week, “Healthcare Interoperability: Who’s The Tortoise?”

  1. If Big Data is the new oil in healthcare, clinical business intelligence is the refinery.

    -Brendan Fitzgerald, HIMSS Analytics, “Infographic: The future of clinical & business intelligence in healthcare”

  1. Congress doesn’t think that the marketplace has created the interoperability it thought it was mandating in the HITECH Act. The right question is: How do we ensure that patients, clinicians and caregivers all have read and write access to a patient’s longitudinal health record in real time? More generically, how do we ensure that the right information gets to the right person at the right time?

    -Flow Health Blog, “Beyond Interoperability”

  1. “information blocking” – I believe this concept is like the Loch Ness Monster, often described but rarely seen.   As written, the information blocking language will result in some vendors lobbying in new political forums (Federal Trade Commission and Inspector General) to investigate every instance where they are getting beaten in the market by other vendors.  The criteria are not objective and will be unenforceable except in the most egregious cases, which none of us have ever experienced. We are in a time of great turmoil in healthcare IT policy making.   We have the CMS and ONC Notices of Proposed Rulemaking for Meaningful Use Stage 3, both of which need to be radically pared down.   We have the Burgess Bill which attempts to fix interoperability with the blunt instrument of legislation.  Most importantly we have the 21st Century Cures Act, which few want to publicly criticize.   I’m happy to serve as the lightening rod for this discussion, pointing out the assumptions that are unlikely to be helpful and most likely to be hurtful

    -John Halamka, Life as a Healthcare CIO Blog, “21st Century Cures Act”

  1. The good people in Congress recently asked ONC: When it comes to the nationwide roll-out of a connected health IT system, are we getting our 28 billion dollars’ worth?

    -HealthBlawg “Locked Down or Blocked Up? ONC Report on Health Information Blocking”

  1. The bill abolishes theHealth IT Standards Committee and proposes to have the work of developing interoperability standards contracted out though usual procurement channels, and reviewed and approved by NIST and the Secretary ofHHS in addition to ONC. It also requires attestations by EHR vendors as to their products’ compliance with the interoperability standard, and it calls for the creation of a federal website that will have full transparent pricing for every certified EHR (and its components and interfaces) 

    -David Harlow, JD MPH, Principal, The Harlow Group LLC, “Whither Interoperability”

  1. The U.S. healthcare stakeholders include patients and individual physicians. Unfortunately, these two stakeholder groups are seldom represented in technical standards organizations and, more importantly, have almost no purchasing power when it comes to electronic health records or health information technology. This contributes to the slow rate of progress and has created significant frustration among both patients and physicians. The beauty of patient-driven interoperability is that ancillary infrastructure is helpful but not mandatory. As with auto-pay transactions with your bank, directory services are not required and certificate authorities are already in place. Certification tests would still be needed but the the Internet provides ample examples of open tests and self-asserted certification that would bypass most of the delays associated with legacy methods.

    -Adrian Gropper, MD, The Health Care Blog, “Patient-Driven Interoperability”

  1. I believe that the sufficient conditions for interoperability include the following:
    *A business process must exist for which standardization is needed. As Arien Malec put it recently, ‘SDOs don’t create standards de novo. They standardize working practices.’
    *A proven standard then needs to be developed, via an iterative process that involves repeated real-world testing and validation.
    *A group of healthcare entities must choose to deploy and use the standard, in service of some business purpose. The business purpose may include satisfying regulatory requirements, or meeting market pressures, or both.
    *A ‘network architecture’ must be defined that provides for the identity, trust, and security frameworks necessary for data sharing in the complex world of healthcare.
    *A ‘business architecture’ must exist that manages the contractual and legal arrangements necessary for healthcare data sharing to occur.
    *A governance mechanism with sufficient authority over the participants must ensure that the network and business frameworks are followed.
    *And almost no healthcare standard can be deployed in isolation, so all of the ancillary infrastructure (such as directory services, certificate authorities, and certification tests) must be organized and deployed in support of the standard.

    -John Halamka, Life as a Healthcare CIO Blog, “Standards Alone are not the Answer for Interoperability”

  1. Sometimes things are so ill-advised, in hindsight, that you wonder what people were thinking. That includes HHS’ willingness to give out $30 billion to date in Meaningful Use incentives without demanding that vendors offer some kind of interoperability. When you ponder the wasted opportunity, it’s truly painful. While the Meaningful Use program may have been a good idea, it failed to bring the interoperability hammer down on vendors, and now that ship has sailed. While HHS might have been able to force the issue back in the day, demanding that vendors step up or be ineligible for certification, I doubt vendors could backward-engineer the necessary communications formats into their current systems, even if there was a straightforward standard to implement — at least not at a price anyone’s willing to pay

    Anne Zieger, EMR & EHR, “HHS’ $30B Interoperability Mistake”

  1. This is one of the most public and noteworthy conversations that has taken place on the issue of patient identification. It’s time that Congress recognize the inability to accurately identify patients is fundamentally a patient safety issue.

    Leslie Krigstein, CHIME Interim Vice President of Public Policy,  EMR & EHR News Blog,  “Patient ID Highlighted as Barrier to Interoperability during Senate HELP Hearing”

 

Free Webcast on Galen’s Note Form Reporting Solution

Noteform reporting 1

Please join us for a free webcast on Wednesday, July 15th at 2pm EST as we discuss an overview of Galen’s Note Form Reporting solution and the new charge automation functionality available within the Note Form Reporting software. We will also cover client success stories of how clients are using this solution for efficient and successful PCMH, Medicare Advantage, and ACO documentation and tracking.

To register, please visit: http://www.galenhealthcare.com/event/note-form-reporting/

 

 

For the Users, By the Users: ERUG 2015

ERUG1

The 5th Annual Allscripts Eastern Region Users Group Summer Conference was held last week at the posh, “boutique design” W Hotel in downtown Atlanta, GA. True to its motto, “For the Users, By the Users,” the ERUG conference proved to be a collaborative and informative educational and networking event for clients and vendors alike.

The educational sessions focused on topics such as patient tracking, optimization, ICD-10, and patient engagement. In addition, Allscripts shared their roadmap and updates for the TouchWorksTM product and provided color around services and solutions including EHR upgrades, mobility, Meaningful Use reporting, clinical notes strategy, and architecture advisory. We also had meaningful discussions with clients on topics including EHR downtime, custom interface development and support, CIE migrations, and application portfolio management.

Galen’s Vice President of Clinical Solutions, Rita Owens, presented on Galen’s Note Form Reporting solution, which aides TouchWorksTM V11 Note Form users in efficient and successful PCMH, Medicare Advantage, and ACO documentation and tracking. Rita also shared new Note Form Reporting charge automation functionality and recent client success stories.

Of course, a conference wouldn’t be complete without some fun! Galen sponsored both the networking reception Wednesday evening and the Cirque du Soleil ERUG member appreciation event on Thursday evening at Opera Nightclub.

Special recognition to ERUG President Jeff Ciccanti and the rest of the board for their tireless efforts in organizing a spectacular conference and ensuring it went off without a hitch.

 

Allscripts Analytics Platform – Do You Have the Latest News?

AAP

As Meaningful Use, PQRS, and CPCI have developed over the past few years, so have their reporting capabilities.  The race to achieve MU-required goals as well as a pattern of late-in-the-year Final Rule updates from Congress have required vendors to rapidly update reporting algorithms.  For Allscripts, what began as the Stimulus Reporting Portal with v11.2.3 migrated to the more robust Allscripts Analytics Portal (AAP) in v11.4.1.

In keeping with the ever-changing landscape, AAP 15.2 was deployed to Production on June 9, 2015.  There are the usual logic changes, however at a higher number than seen in the past.  In fact, there were enough significant issues during UAT testing that this update was delayed for several few weeks.  This latest version brings numerous logic, value set, and even workflow changes – 21 pages of calculation changes to be exact!   Whenever there is an update to the AAP, every organization’s data will be recalculated, and this can take several days for the process to finish.  As of the date of this publication, Allscripts is expecting this process to be completed by the end of the week.  Remember that the dropdown for the 2015 reports will be unavailable until the data has reprocessed.

A major change to note is in workflow NQF 0028- Preventative Care and Screening for Tobacco User:  Screening and Cessation.  In 2014, physicians were credited if counseling was entered as an order, but for 2015, the order must also be in a “completed” status to count in the calculation.  The numerous updated measures will have a new section in the configuration document called “Changes from 2014 to 2015”.  The specific measures affected can be found here with helpful hyperlinks.

With the combination of increasing alternative payment model adoption and the impending code set change to ICD-10, it stands to reason that audits will increase.  It is has become increasingly important to not only have accurate reporting in place, but to also develop the contextual connection to that information.

Recommendations:

  • Subscribe to the AAP Blog to automatically receive email updates
  • Run and validate reports regularly
  • Always export reports to excel and save them! This is important for audits, but perhaps even more important for validation testing processes.
  • Keep careful records of what a report represents for the organization. A detail as simple as a specific consistent naming convention helps delineate changes, and creates a defensible audit position.
  • Keep a calendar or diary of the changes applied, not only for audit purposes, but also for ease of knowledge transfer between team members. For example documentation should include Plan of Correction Actions taken for workflow changes and confirmation of changes to existing configurations.

The healthcare atmosphere requires careful balancing between the many competing objectives of healthcare reform.  If you have further questions or feel your organization could use the strategic insight and proven solutions that Galen Healthcare Solutions offers, don’t hesitate to contact us at sales@galenhealthcare.com.

Resources:

Allscripts Analytics Platform Documentation: https://clientconnect.allscripts.com/community/toolbox/doc

Allscripts Advisory Blogs:  https://clientconnect.allscripts.com/docs/DOC-33108age

Allscripts Changes 2014 – 2015 Announcement: https://clientconnect.allscripts.com/docs/DOC-19659

Successfully Attest for Meaningful Use While Simultaneously Converting to a New EHR

MU Conversion2

With seemingly everyone trying to consolidate and take advantage of economies of scale, some of the biggest trends in today’s dynamic healthcare landscape are conversions and mergers.  Is your organization making the move to a new EHR?  Is your group entertaining the idea of acquiring another hospital or outpatient facility?  Outside of the business-related articles that will directly impact an organization during an acquisition, there are many other important items to take into account that may fly under the radar.

One of which is Meaningful Use, and the ability to effectively manage both the conversion from a Legacy system to your new Target EHR, and your physicians’ MU successful attestations.  We find it wise to consider the following prior to kicking off a project:

  • Are there resources in place and are they experienced?
  • Is the conversion team skilled enough to populate all necessary fields with the appropriate information for MU reporting?
  • Are there configuration experts available from both EHRs who can collaborate and communicate effectively about the MU requirements?
  • Is the project manager experienced with other conversions and does he/she understand the caveats that come with MU reporting?

Although Meaningful Use is tapering down, don’t leave any of that money on the table!  To learn more about how to manage an EHR conversion and MU attestations simultaneously, join us for a free webcast this Friday, June 19.  Having facilitated many EHR conversions, Galen is uniquely positioned to partner with healthcare organizations who are about to engage in such an undertaking.  We have the system analysts, MU resources, and technically savvy specialists to give the proper recommendations and project leadership that will provide your organization with a leg up in keeping things on track.  Managing multiple projects is always a difficult task, but with enough foresight and preparation, you can position your organization for success, despite the interdependent project timelines.

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