Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

We have received a warm response to eCalcs, Galen’s latest bolt on for the Allscripts Enterprise EHR.

We have received a lot of compliments along the way – integrated health calculators are much needed, that Galen put out a thoughtfully crafted product, and even that we finally listened a built this type of add-on tool that makes providers happy. That last one is my favorite – it’s a tough time for providers with the rush to Meaningful Use and now to ICD-10, many feel that they are taking on more work with lower results. If we can provide a “cool tool” that makes life easier, I couldn’t be happier.

What we have also received are plenty of questions about how it works. You can cite the scores into a Note? How are the scores stored in EHR – as Results? Questions like those.

This How To video will help answer those questions. It’s just under three minutes long and covers the major functionality within eCalcs and its integration with the EHR.

Our marketing firm also sent over a concise and rather visually pleasing brochure for eCalcs. Thanks guys!

Tags: Allscripts Application Integration, Allscripts Enterprise EHR, EHR eCalc, Extensibility, Framingham Risk Calculator, Galen eCalc, Integration

—Discrete Clinical Data Elements as the building blocks to a Connected Health Platform—

Broken down to its basis, any vision of a truly connected Health Network will be reliant on the ability to pass, and ultimately present, discrete data elements.  Although the audiences for the information will be diverse, and the front-end systems will vary, the foundation of the information is the same.  In order to unlock the value that lies in the data being captured every day, an organization must have solid planning and execution. 

Each organization we work with is unique, but overall themes are constant: Reporting for Meaningful Use, Optimizing Health Care Decisions with Analytics, and Growth through Acquisition or Partnership.     

If we consider Clinical Data as building blocks that will be used, in whole or part, to support these efforts, we need to ensure both the ease of access and integrity of that data.  Galen has leading expertise and insight on conversions, reporting, and interfaces that can help you down this path. 

So how do you take the first steps in creating solid building blocks?  We would recommend to:

Define and establish consistency in electronic documentation and workflow.  This starts by understanding the EHR build and configuration decisions that will impact both availability and integrity of the data.   This consistency will also pay dividends to the organization by making the support of the Enterprise EHR system more predictable and efficient. 

Independent of your organization’s current state, Galen has the breadth and depth of expertise to help achieve your vision.

Tags: Allscripts Consultants, Allscripts Enterprise EHR, Clinical Conversion, Data Conversion, EHR Implementation, Enterprise EHR, Healthcare IT, Interoperability

In last quarter’s newsletter we were excited to announce our Galen Certified-Enterprise EHR Application Specialist training and certification program. Today we are proud to share the news that this quarter we added another eight employees to this distinguished group!  

During the 7 weeks of training not only are all modules of the Enterprise product discussed in great detail with an added emphasis of clinical relevance, but each student must demonstrate a complete knowledge and understanding of the Certified Workflows. Prior to taking both a written and verbal examination on Enterprise fundamentals, each student must successfully build out an entire Enterprise environment from the ground up!

Please join me in congratulating the following…Galen Certified™ Enterprise EHR Application Specialist!

 

Steven Beaucaire, Consultant

Steven joined Galen on September 11, 2011. He comes with us with over 14 years of healthcare experience. He has extensive experience in project management and business operations as well as in-depth knowledge on how technology and healthcare can work together to ensure patient safety and continuum of care. He has significant knowledge on how ambulatory clinics and acute facilities interact within a healthcare organization. His extensive experience as a manager in both clinical and business settings within a healthcare consortium provides an exceptional perspective on today’s healthcare demands. He looks forward to a long and prosperous career at Galen. Steven currently resides in Lewiston, Maine.

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 August Borie, Consultant

August joined Galen in January 2011 as a member of the upgrade team, helping to get clients ready to demonstrate Meaningful Use. He worked as both a Project Manager and Upgrade Consultant on this team, while building his Enterprise EHR application experience. Most recently he is working with a client in Portland, Maine on an upgrade and implementation rollout. August graduated from the University of Vermont in 2010 with a Bachelor’s degree in Computer Science Information Systems.

 

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Elise Brault, Associate Consultant

Elise joined Galen in November 2011 as an Associate Consultant and completed Galen’s Certification program in December. Elise graduated from the University of Vermont with a Bachelor’s Degree in Recreation Management. She completed master’s degree coursework in Business Administration at St Michael’s College and also recently completed the Health Information Technology Certificate Program at the Community College of Vermont. Elise brings her diverse background in business, healthcare, and management with her drive for customer service excellence to the Galen team. She looks forward to providing Galen clients with EEHR systems expertise and unsurpassed service.

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 Barry Chamberland, Associate Consultant

Barry joined Galen in November 2011, having previous experience as a Software Quality Analyst testing clinical applications and workflows. He has been involved in website development for many years and looks forward to expanding his knowledge and expertise in the Allscripts Enterprise EHR™. Barry lives in Burlington VT, and graduated from the University of Vermont in 2004 with a Bachelors Degree in Recreation Management.

 

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Jon Deitch, Associate Consultant

Jon joined Galen Healthcare in November of 2011. He graduated from the University of Vermont in 2009 with a BA in Political Science and English. He enjoys Skiing, Music, World History, and Traveling.

 

 

 

 

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Evan Lea, Consultant

Evan joined Galen in May of 2011 as an Implementation Consultant. He graduated in 2009 from The University of Vermont with a degree in Marketing. Since joining Galen, he has quickly come up to speed with the front end and configuration of Enterprise EHR. He has recently been working closely with Catholic Health Initiatives in the Midwest with user support, EHR configuration, and build work as they move towards bringing over 500 clinics live in one integrated system.

 

 

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Kyle Paya, Consultant

Kyle came to Galen in 2011 from UVM with a Bachelor’s Degree in business administration with a concentration in entrepreneurship. Kyle has been part of the success of a multi-million dollar company with focus on project management, inventory management, and operations planning. During his tenure at the aforementioned company; he also designed, built, and implemented the company’s first formal inventory management database mainly for the managerial accounting initiative he introduced. Kyle has been a Project Manager on six (6) v11.x to v11.2 upgrades in 2011. He also became a Galen Certified – Enterprise EHR Application Specialist during this time. As 2011 came to a close, he made a transition to consultant on the professional services team and joined the Galen group at Lexington Medical Center. There, he is helping bring sites live on Allscripts EEHR while also working with the hospital group’s upgrade team as they under-go their own v11.2 upgrade.

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Chelsea Stovall, Consultant

Chelsea joined Galen in September of 2011 as an Implementation Consultant. She graduated from the University of Texas at Austin with a B.S. in Human Biology. Following graduation, she completed a Postbac program at UT Austin in Health Information Technology and received her Health Information Technology Manager and Exchange Specialist certification. She has over a year of experience in EHR training, work flow design, go-live support and EHR customization.

 

 

 

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Tags: Allscripts Consultants, Allscripts Enterprise EHR, EHR Certification, Enterprise EHR

In order to be able to truly consult and to make sound recommendations on how to approach certain clinical data elements it is important to know what options exist.  One of the main goals heading into a conversion project is to be able to convert as much data as possible in a verified state.  Converted items that file into EHR in an already verified state are ideal since they will appear and behave very similar (if not the same) as data that was directly entered into EHR.  Unverified items will require that a user and/or provider use the Verify and Add functionality in EHR to promote the item to a verified status.  The Verify and Add process guides the user/provider to the appropriate ACI workspace where the unverified item can be queried against the master dictionary, matched up to an appropriate entry, and then committed as a verified item into the record.

Here are some of the essential advantages/disadvantages and potential decision points that might assist in the decision making process with regards to verified vs. unverified data sets.

Impact on workflow and clinical staff – it is important to be aware of the fact that filing items such as Allergens, Problems, and/or Medications as unverified items requires not only additional training and workflow augmentation for the Verify and Add process, but also can take a considerable amount of time and almost make an established patient feel like a new one.  Consideration should be given to how the Verify and Add process could potentially fit into the intake process and what (if any) additional resources might be justified in order to Verify and Add items prior to the visit; very similar to chart abstraction.

DUR checking – when considering handling Medications and Medication Allergens as unverified items, it is crucial to understand that DUR checking will NOT take place for unverified items; only for verified items.

Integration with Note – unverified items will NOT fully integrate and auto-cite into a structured note.  This is important to know so that there is awareness that items (such as Problems and Meds) need to be verified prior to starting a note if it is desired to have those items auto-cite into the Note.  This could adversely impact the amount of time it takes the provider to retrieve information for clinical decision making and also impact on the clinical documentation for the visit.

Charge capture – Problems that are in an unverified state cannot be assessed via the Note or Clinical Desktop.  In order for a problem to be assessed in EHR and electronically charged for it must be a in a verified state and associated with a valid ICD9 code.

Display text – when an unverified item is constructed and filed it basically is a string of textual information prior to the Verify and Add process.  This is significant because once an item is verified against a native EHR dictionary entry it will take on the display name and attributes of that EHR item.  The display name sent over with the unverified item will not persist past Verify and Add so it is important to know what information will remain and which information may need to be keyed in as an additional description or annotation.

The decision to ultimately proceed with verified vs. unverified items can also be driven by external factors related to the legacy system in combination with EHR specific criteria.

Does the source system allow “free text” or “un-coded” items to be added to their clinical record? 

Are these items confidently translatable to any of the dictionary items in EHR?

Are the required data dictionary extracts something that the legacy is able and willing to provide in an accurate and timely manner?  What is the cooperation level of the legacy vendor?

Consider a situation where the legacy system allows the free text “ad hoc” entry of un-coded Allergens in their clinical record and line items such as “Tylenol/Milk/Blue Dye”.  This is a challenge since it is really 3 unique allergens combined into one item.  Since this contains both medication and non-medication related allergens it would not be appropriate to build this as its own entry in Allergen dictionary.  That being the case there is likely nothing to map an item such as this to in EHR.  This situation could then present itself as an appropriate candidate for unverified items.  That way at the point of review and intake (or during chart abstraction) this item can be reviewed, confirmed, and then split out into 3 unique EHR entries that will properly partake in DUR checking and be safer for the patient.

Tags: Allscripts Enterprise EHR, Data Conversion, Enterprise EHR

The conversion implementation consultant is a dynamic project role which includes multiple responsibilities that serve an important function towards the successful execution of a discrete clinical data conversion.  It is a versatile role that requires some level of technical and logistical insight to navigate the project effectively and efficiently.  The conversion IC is also one of (if not) the frontline project resources that drive to ensure integrity, accuracy, and patient safety are kept in high regard during the conversion process.  Not only is the conversion IC responsible for defining, managing, and executing conversion build tasks that are functional in nature, but to also guide and inform the client towards decisions that will assist in adding optimal value and ensure a smooth transition from the legacy system.  The following are some functional responsibilities of the conversion IC defined in greater detail with an emphasis on conversions from legacy systems to EHR.

Dataset Mappings 

Even though most EMRs set out to fundamentally accomplish the same goals and to some extent offer similar functionality; they are understandably different in many ways.  In general, target systems (converting to) do have to accommodate some level of additional build work in order to account for gaps or differential dictionary content that the source system (converting from) could potentially provide or want to convert.  Identifying these gaps and helping the client to build their data set translations is a major (if not the primary) function of the conversion IC.  These translations or “crosswalk” files are typically manifested in a spreadsheet or flat file and then supplied to the interface and/or integration engineers on the project to install in the inbound interface or database engine.

In general it is recommended that a clinical resource be involved in the data mapping and approval process to ensure that clinical integrity is maintained throughout the conversion process.  Data elements that generally require an interface translation or crosswalk from the source system to the target system are:

Allergens (Medication & Non-Medication)

This dataset involves obtaining extracts from both the legacy and EHR system in order to generate a mapping from the legacy system to EHR.  It helps to handle the medication and non-medication allergen translations as individual crosswalks.  Both types of EHR allergens (medication and non-medication) can be handled as unverified if a translation cannot be established.

Codification values à NDC values can help to automate this process if supplied by the legacy system.

The EHR allergen (non-medication) dictionary can be obtained by running a SSMT extract via the allergen content category.  The medication allergen EHR dictionary must be extracted from the EHR database by a technical resource and provided to the conversion IC.  Any non-medication allergens provided by the legacy system that do not map or exist in the target system (EHR) would need to be built in EHR.

Medications

This dataset involves obtaining extracts from both the legacy and EHR system in order to generate a mapping from the legacy system to EHR.  Due the size and complexity of most EMR medication data dictionaries it is important to consider the amount of time and clinical input required to procure, establish, and test a translation involving medications of a variety of statuses.  Medications can be handled as unverified items if a translation cannot be established.

Codification values à NDC values can help to automate this process if supplied by the legacy system.

The EHR medication dictionary must be extracted from the EHR database by a technical resource and provided to the conversion IC.

Problems (includes Active, Past Medical Hx, Past Surgical Hx, Past Social Hx, Past Family Hx)

This dataset involves obtaining extracts from both the legacy and EHR system in order to generate a mapping from the legacy system to EHR.  Due to the size and complexity of most EMR problem based data dictionaries it is important to consider the amount of time required to procure, establish, and test a translation involving problem entries and categories of multiple statuses; especially cases where a 1-to-many relationship between the source and target system may exist and needs to be resolved.  Problems (all categories) can be handled as unverified items if a translation cannot be established.

Codification values à ICD9, CPT, and/or SnowMed values can help to automate this process if supplied by the legacy system.

The EHR problem dictionary must be extracted from the EHR database by a technical resource and provided to the conversion IC.

Vital Signs

This dataset involves obtaining extracts from both the legacy and EHR system in order to generate a mapping from the legacy system to EHR based on the code values of each vital signs component (orderable and resultable).  EHR vital signs are technically enforced findings, but live in the EHR orderable item dictionary.

The EHR vital signs order and associated result codes can be can be manually retrieved from the orderable item dictionary since the number of items is manageable.  Obtaining these order and result code values is recommended directly from the orderable item dictionary so that the relationship between orderable item and resultable item is kept intact otherwise this can lead to errors upon filing into EHR.

Documents (Unstructured Notes)

This dataset involves obtaining a list of document type codes from both the legacy and EHR system in order to generating a mapping from the legacy system to EHR.  Converted documents are typically filed with a status of “Final – Receipt” since in most cases only finalized or verified documents are migrated from legacy systems.

The EHR document type dictionary can be extracted via the document type SSMT category and filtered to “RTF” manifestation type by the conversion IC to produce a list of potential target EHR unstructured note types.  Any document types provided by the legacy system that do not map or exist in the target system (EHR) would need to be built in EHR.

Images (Scanned Images)

This dataset involves obtaining a list of document type codes from both the legacy and EHR system in order to generate a mapping from the legacy system to EHR.  Scanned image file types and formats can vary in their manifestation types from system to system so it is important to understand if additional technical manipulation will be required up front to prepare the documents in a format that EHR will accept and properly display.

The EHR document type dictionary can be extracted via the document type SSMT category and filtered to “TIFF” manifestation type by the conversion IC to produce a list of potential target EHR scanned image types.  Any document types provided by the legacy system that do not map or exist in the target system (EHR) would need to be built in EHR.

Immunizations

This dataset involves obtaining an extract from both the legacy system and EHR in order to generate a mapping from the legacy system to EHR.  Depending on the functionality available to end users in the source system this extract is typically low to medium in terms of size and complexity.  Immunizations can be handled as unverified items if a translation cannot be established.

The EHR immunization dictionary must be extracted from the EHR database by a technical resource and provided to the conversion IC.  These are essentially medication entries that have entry codes starting with “CV”.

Results

This dataset involves obtaining an extract from both the legacy system and EHR in order to generate a mapping from the legacy system to EHR.  Depending on the number of lab vendors and current setup of the target system (i.e., synchronization) it is important to consider time and level of clinical involvement.  One of the advantages of executing the Order/Result conversion mapping is the ability for flow sheets to continue to flow historical data in a longitude format.  It also prevents from having to build additional and potentially erroneous entries in the orderable and/or resultable item dictionaries just to house converted data.  It is generally the case that both the orderable items and resultable items will need to be individually mapped in order to honor to the relationship between the parent orderable item and resultable components.

Codification values à LOINC or CPT codes can help to automate this process if available from the legacy system and if assigned to EHR orderable items in the Orderable Item Dictionary.

The EHR orderable item dictionary  and associated resultable items can be obtained by running a SSMT extract on using the Order-Results v11 content category.  The resultable item dictionary itself can be obtained by running a SSMT extract using the RID – Resultable Item Dictionary content category.

Click the following link to read Part 2 of this article:

The Role of the Conversion IC Part 2: Verified vs. Unverified Data Sets

Tags: Allscripts Enterprise EHR, Data Conversion, Enterprise EHR

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

 In this demo, we will present Allscripts Enterprise EHR and RelayHealth Portal integration capability. This solution facilitates seamless integration between the two applications, offering single sign-on, messaging between provider and patient,and patient online indicator functionality.

Contact us today so your organization can realize the compelling benefits of Enterprise EHR RelayHealth Portal integration.

Tags: Allscripts Enterprise EHR, Allscripts Patient Portal Integration, Application Integration, EHR Patient Portal Integration, Enterprise EHR, Extensibility, Integration, Patient Online Indicator, Patient Portal Integration, RelayHealth, Single Sign-On

 

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

 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

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