As many of you know the ACE 2010 event just took place last week. As I was pouring through some of the handouts I couldn’t help but be drawn into the “Handy Trail Guide” which Allscripts has touted as “The Path to Meaningful Use” This is a great high level guide to reaching Stage 1 of Meaningful Use – Capture and Share Data.

The more I read through this the more I thought of how clients will be looking at this with an eye to the shortest path to receiving their stimulus check, and rightfully so – every group should be looking to take advantage of this, from the largest hospital to the smallest single-doc practice. However, I wanted to make sure we don’t lose sight of the forest from the trees here and bring this trail guide back to the true reason for the stimulus – improving patient care! Hence the genesis of this article, The Path to Meaningless Use.

There are a couple of main points I’d like to highlight before dissecting the step by step approach.

1. Sell benefits of the EHR – I feel like this process is woefully underappreciated. In order for your rollout to be a success you absolutely need buy-in from all end-users, including physicians, nurses, data-entry folks and really any person that will touch the EHR on any level. How is this product going to improve their productivity? Make their job easier? Make their work experience more enjoyable?
2. Change is a good thing – Change is the process by which innovation and improvement are instilled. I know that people are comfortable with the status-quo and yes, change for change sake is useless, but there’s a reason for change here, I promise! Challenge your co-workers to look at everything objectively and really question if the products and processes currently in place really make sense or if there could be a better way.
3. Make concessions, don’t over-customize – The product is designed to work best when used in an out of the box capacity, sans customizations. The reality is that you probably aren’t going to be able to sell the idea of changing every workflow to fit the product, but that doesn’t mean you shouldn’t try. Ultimately in the long term the stability of the system is most closely tied to how close you stay to it’s intended use, therefore fight for those process changes to model the system, there’s a reason the EHR was designed the way it was! This point goes back to selling the benefits, be able to show how using the new workflows will actually improve the end-user experience!

With those main points made here are a few comments on the step in the Path to Meaningless Use, enjoy!

1. Understand Stimulus – Don’t just aim for the stage 1 level of capturing and sharing data, yes this can improve productivity but don’t lose sight of the true end goal, improving patient care.
2. Assess Gaps – Be honest with yourself. Are the tools you are using as efficient as they could be? Don’t keep old processes and tools in use just because people are “comfortable” with them, if there is a better tool out there, use it! Sometimes taking people out of their comfort zone is exactly what is needed to promote healthy growth.
3. Design New Workflows – Don’t be unwilling to change workflows simply because that’s the way it’s always been done. Be prepared to pitch workflow re-design to physicians with benefits for them in mind.
4. Upgrade EHR & Stimulus Set – Don’t rush this upgrade. There are many factors that go into an upgrade (depending on how many versions you are jumping) and simply upgrading for the sake of getting the stimulus approved version may end up biting you if you haven’t correctly re-worked process flows to use the EHR in a meaningful way.
5. Rollout – During training stress benefits to end users, a 3 day crash course on the new EHR system is great but if you can’t prove to your end users why the new product and workflows make sense you aren’t going to receive full buy in and consequently won’t get the most out of the product.
6. Begin 90-day Meaningful Use – Metrics should be kept on an ongoing basis, not just for 90 days. It’s great to hit the 90 day plateau to receive the stimulus check but the true purpose of the EHR is to improve patient treatment, and you can’t improve what you don’t measure.
7. Report & Claim Stimulus – Nothing meaningless about this step, claim the money and move on to the next stage!

We want to say special congratulations to all of our winners!!!

Susan Schimpf, from CapitalCare Medical Group, won the $200 Spin and Win Grand Prize

Melissa Singh, from North Shore Long Island Jewish, won in the drawing for the free iPad!

Over FIFTY $10 casino chips prizes were given to Galen slot machine winners and to those faithful followers caught out and about wearing their “Win with Galen” stickers!

Thanks to all of those that participated – we had a blast!

For us here at Galen it was a great time to see old friends and clients, as well as, meet new friends and clients all in a setting that facilitated learning, sharing and connecting our collective community; of course, having a little bit of fun along the way doesn’t hurt.

By far the most rewarding part of ACE is connecting with our clients and hearing about the successes our people have made, both on an individual level as well as a community level.  There is nothing more rewarding than hearing a client’s success story and being able to share with our group the service that someone from Galen provided.

In the coming year, we look forward to our continued contributions and learning from our people, clients and community.  Nothing contributes to innovation more than a passionate community.

It was great to see all of our old friends, and we look forward to making new ones.

Matt Nice

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

Some of my own key highlights and takeaways from ACE:

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

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

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

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

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

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

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

A recent issue came up with one of our clients in that interfaced patient appointments from their Practice Management system were not making it in a timely manner to the EHR. The client witnessed that appointment messages built up in the interface queue and there was a delay in processing the messages. The client desired a resolution that would assist in speed up of the processing of the messages such that appointments booked in PM would render in the EHR quickly without a disruption to workflow.

Investigation:

Enter the ConnectR Toolbelt “Transaction Processing Time” report:

This report extracts transaction count, minimum, average, and maximum ConnectR processing time per hour. Using the report, the following analysis was conducted.

Findings:

Based on the aforementioned analysis, it was determined that in the clients Live Reg/Sched system target, blocked messages were being logged. Having blocked messages logged can be invaluable when first designing and developing interfaces. However, as evidenced in the analysis, it can lead to performance degradation as the system requires much less processing time when messages are not logged.

Outcome:

Logging of blocked messages in the Live Reg/Sched target was disabled on 6/30/2010 and as witnessed in the analysis spreadsheet the number of transactions decreased by roughly 70% and peak transaction processing time decreased by roughly 90%.

Our Wiki content has been driven so far by the knowledge and experience that our consultants gain in the field.    We have gotten great feedback from clients and end users that the wiki is a great resource, and we feel that this program will only serve to enhance that process.    We want to hear what you are struggling with, where you are stuck and where you need a work-around.

Using this link users can submit questions to our website and our team of experts will review the questions and use them to direct future content for the wiki.   We also plan to highlight one question from the “Ask the expert” series in each Newsletter.     We expect that there could be a high volume of questions and we may not be able to answer all of them,  but we will review all submissions and evaluate the utility of the answer to the greater user community as well as looking for trends when multiple users ask similar questions.       We are looking forward to hearing from you!

Learn more »

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

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

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

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

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

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

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

Steve McQueen

This is exactly what VitalCenter can now do. Traditionally, pulling medical records for Insurance Audits has been a time consuming and costly project that raises concerns about patient privacy and EHR performance.  VitalCenter 2.0 provides a cost-effective and efficient way to provide patient records to auditors while eliminating concerns about patient privacy and EHR performance.   

One of Galen’s VitalCenter clients asked our development team if there was a way they could use the VitalCenter product to provide medical records of a select group of patients to an auditor.    Working collaboratively with this partner we were able to develop a custom feature that will be included in the next general release of VitalCenter.   

Insurance companies hire vendors to perform an Audit at a rate of $2-3 a chart.   The medical providers then have the responsibility of providing auditors with office space, training the auditors on the use of the EHR and often provide staff to supervise the work of the auditors.  Not only are these audits time consuming and costly for medical providers, but they also have implications for patient privacy and EHR performance.    There is currently no way within the EHR to restrict the access of auditors to a pre-defined group of patients.  Additionally, a group of auditors printing entire charts via the EHR can result in major performance issues with the print server in the production system.

Now, Auditors can provide the medical providers with a list of patient names to be included in the audit.   The patient names are uploaded into a secure web portal and a zip file is generated containing the entire patient chart for each name on that list.   These can be provided electronically to the Insurance company in the form of PDF files or printed documents – all without the overhead expenses of a traditional audit, without privacy concerns for patients excluded from the audit and without affecting performance on the live print server.

Max.Henson-Stroud

Justin Campbell Promoted to Senior Consultant

Galen Healthcare is pleased to announce the promotion of Justin Campbell to Senior Consultant.  He has been an Interface Analyst with Galen Healthcare Solutions since 2008. Justin is a key member of the Galen Technical Services team and a few highlights of his responsibilities include development of new interfaces, enhancement  of existing interfaces, development of training environments, development and deployment of customized application solutions for Allscripts Enterprise, and implementation of SQL server upgrades. Justin works with many large and complex customers including MSO environments and clients with over 40 interfaces.

Justin developed the Solutions Store, where clients can purchase and download reports.  He is currently leading a project to build a new product (ConnectR Toolbelt)  that will enhance the end user experience of working with ConnectR.  Justin has a passion for improving the world of healthcare IT and is a regular contributor to many Healthcare IT blogs.    Justin also conducts free webcasts covering ConnectR Interfaces.

Prior to joining Galen Healthcare, Justin Campbell was an IT Director overseeing IS operations of pharmacy information systems. His responsibilities included overseeing daily operations and support, integration of new hardware and execution of a conversion from a legacy pharmacy information system to a SQL based pharmacy information system.

Cecil Hunter Promoted to Senior Consultant

Galen Healthcare is also pleased to announce the recent promotion of Cecil Hunter to Senior Consultant.   Cecil joined Galen in 2008 bringing with him a wealth of knowledge and expertise from over 8 years of working in healthcare and 4 years of working with Electronic Health Records.     Cecil is a seasoned implementation consultant with a passion for providing the kind of leadership and support to healthcare organizations that allows them to optimize their use of the EHR and fosters end-user investment in the system.

Cecil has become an integral member of the implementation teams on which he has worked and clients have frequently requested him when they have had projects that need a highly skilled and effective consulting partner.   Cecil has in depth experience with Allscripts Enterprise EHR build and design, planning and supporting phased go-live support to multi-specialty clinics and providing presentations on new functionality to management and project decision makers. Additionally, he has experience in supporting system analysts and trainers in providing the best possible end user experience.

Prior to joining Galen Healthcare, Cecil was an Allscripts Super User for a large multi-specialty healthcare organization.     Cecil provided input on the build & design process, and was a part of end-user support from training through post –go-live.    Cecil approaches his work with the deep understanding that improving the end user experience leads to improved patient care.