Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

Client: MedNetworx – Azalea Orthopedics

Project: MedManager PM -> Allscripts PM Conversion

Project Timeframe: April 15^th – June 1^st (6 weeks from initial scoping to go-live)

Client Contact: MedNetworx – Mark Johnson, President and CEO.

Description: Azalea Orthopedics, located in Tyler Texas, has been providing orthopedic surgery, sports medicine & pain management in East Texas for the past 20 years. Azalea employs 130 including 17 physicians who are specialists in orthopedic surgery, physical medication and rehabilitation. MedNetwoRx, a healthcare application service provider (ASP), located in Dallas, Texas, hosts the practice management and electronic healthcare record applications for Azalea. Azalea looked to convert from a legacy PM system, MegManager, to Allscripts PM, as part of consolidating systems to the Allscripts product line. Partnering with Galen Healthcare Solutions, MedNetwoRx leverage their own in-house Allscripts product and physician practice experts as well as Galen’s deep experience with clinical and administrative data conversion.

To facilitate this conversion, flat-file extracts were obtained from MedManager for dictionaries, demographics and appointments. However, instead of using these extracts to import into Allscripts PM, an alternative approach was taken in which real-time appointment and demographic interfaces were deployed from the client’s existing Allscripts Enterprise EHR to the new Allscripts PM environment. This offered the flexibility of having the PM data populate real-time. Interfaces were also required from Allscripts PM to Allscripts Enterprise EHR. Thus as part of the go-live, existing reg/sched interfaces from MedManager to Allscripts Enterprise EHR needed to be deployed.

Utilizing existing data in the Allscripts Enterprise EHR as well as flat-file extracts from MedManager (for more complete insurance and referring provider information), a conversion of dictionaries, registrations and appointments was executed.  Care had to be taken to ensure that appointments loaded into Allscripts PM would be able to map to existing appointments in the EHR and update appropriately instead of creating duplicate appointments. The same consideration had to be made for dictionaries to ensure proper matching on codes.

All patients (inactive and active) and appointments for the previous 2 years as well as future appointments were loaded from the Allscripts Enterprise EHR into Allscripts PM. Since insurance information wasn’t being captured in the EHR, and update of patient’s accounts in PM had to be executed, utilizing flat-file output from MedManager. Additionally, the patient MRN seed in PM needed to be reset as to avoid contention, and insurance and referring provider dictionaries were updated using extracts from MedManager, since the extracts contained more complete data than the EHR.

Conversion Statistics:

Tags: Allscripts, Allscripts Conversion, Allscripts Enterprise EHR, Allscripts PM, Clinical Conversion, Data Conversion, Galen Clinical Conversion Toolkit, Integration, Interfaces, MedManager, MedNetwoRx, MSO, Multi-Org, PM Conversion, Practice Management Conversion

Introducing the Allscripts Interface Developers Network – a forum for Allscripts integrators by Allscripts integrators. The site is intended to facilitate knowledge-share and collaboration within the Allscripts integration community.

Too many of us live in silos and don’t have the means necessary to collaborate and exchange knowledge and IP instead of reinventing the wheel. Our hope is to enable our clients and the community to produce integrations that conform to best-practice principles and are efficient and safe in the transfer of critical patient clinical data. The scenarios for collaboration are vast, with just a few examples listed below:

• Design: When designing an interface, an integration analyst may not have the necessary documentation they need concerning the functionality of the API, a list of configuration options, or a template to work off of.
• Scripts (both interface engine and database): Additionally, there may be a need for custom scripts, and perhaps another member of the community has already developed said script.
• Error Remediation and Mitigation: Perhaps an analyst has encountered an error that they have not seen before, yet another group has and has a process for mitigation
• Performance Optimization: We recently encountered a scenario where clients were experiencing performance degradation in their live environment – namely results were taking upwards of three minutes (!!!) from when they were first received in the source system to the point where the processed and filed into the EHR. With a Cached Lookup solution, the client was able to get the processing time back down to a more reasonable value.

You’ll also notice that the forum contains quite a bit of content already. We recently conducted a “soft-launch” of the forum, reaching out to our strategic partners, and got phenomenal response. A special thank you and congrats goes out to Ray Lape, EHR Application Manager at Medisync Midwest. His contributions and collaboration have been outstanding thus far. We know there are more like Ray out there, so please register and begin participation today!

So, as integration questions arise, instead of – or in addition to – emailing to a corresponding interface vendor representative, please post on the forum. Create or branch threads where appropriate. Also note that RSS capability has been enabled on the forum to offer ease of subscription.

Lastly, feedback is certainly important and if there are ways we can improve the site, especially in regards to the forum categories, it is certainly appreciated. In fact, there is a separate forum category that addresses site feedback.

Tags: AIDN, Allscripts, Allscripts Forum, Allscripts Interface Developors Forum, Allscripts Interfaces, Collaboration, Community, ConnectR, Extensibility, Integration, Interfaces, Interoperability, Knowledge Share

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

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

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

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

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

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

Mike Dow

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

VitalCenter 2.0 introduces dozens of new features, including:

Scanned Documents

View scanned images, along with the rest of your patients’ charts. Learn More >

Automate Payer Audits

Generate custom-configured charts, based on a list of hundreds to thousands of patients. Learn More >

Improved Security

Lock down VitalCenter, even on shared PCs. Learn More >

Peer-to-Peer Connectivity

Improved availability of clinical information, with a reduced impact on your network. Learn More >

Same Day Appointments

Access to patient charts during EHR downtime, even when they are scheduled same-day. Learn More >

Tags: Allscripts, Allscripts Enterprise EHR, Business Continuity, Enterprise EHR, VitalCenter

As physicians migrate to the Electronic Health Record, there are many new systems and processes they have to learn and adapt to.  One of these systems is voice recognition software, such as Dragon Medical 10.  I have worked with some physicians recently who were implementing a new EHR in their office, as well as transitioning from a transcription service to Dragon voice recognition.  This introduced some new challenges which I hope to shed some light on in this article.

Dragon Medical has the ability to ‘Type as you Talk’, which allows the user to dictate blocks of text and see this appear in their note in the EHR.  This has a huge benefit to the provider by allowing them to review and finalize their documentation for the visit immediately, rather than waiting a few days to receive the note back from a transcription service.  We discovered that there are some steps that you can take to improve the performance and/or accuracy of Dragon.  Here are a few to note:

1. Spend the time training Dragon to recognize your voice.  During this process, the application will learn how you speak, and adapt to your voice patterns.  This will prove to be very beneficial in the long run.
2. Follow the recommendations for the settings for your EHR vendor.  The Dragon representative will have recommendations on how settings should be configured based on the EHR you are using.
3. When words are not typed correctly, correct them using the built in features of Dragon to Train it on how you speak those words.  This will save you time and energy as you become a more advanced user of the speech recognition software.
4. Have reasonable expectations.  Dragon is a tool that improves over time.  When you first begin using speech recognition software, it only has a basic understanding of your vocabulary and how you speak.  It will take time for the application to improve, which will occur naturally as you train it when words are not recognized correctly.

These are a few items that will hopefully help you be more successful when using speech recognition software, such as Dragon Medical.  I have also found that it is beneficial to have a follow-up training session with Dragon after the user has been using it for a few weeks/months.  At this point, the user understands some basic functionality, and is usually interested in how to do more complex functions such as Macros.

Tags: Allscripts, Allscripts Enterprise EHR, Dragon, EHR Implementation, Enterprise EHR, Integration, Successful EHR Implementation

The Path to Meaningless Use:

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!

Tags: Allscripts, EHR, Meaningful Use, v11 upgrade

This year at ACE everyone was a winner with Galen!  Our booth was alive with activity as folks stopped by to see Galen Healthcare Solutions Wiki demos, VitalCenter Demos, to learn about Galen services and to take a spin on our Galen Slot Machine.  Tons of prizes were given out including entries to win an iPad, $10 in Mandalay Bay Casino Chips, and our Spin and Win Grand Prize of $200 in casino chips!   The last day of the ACE event we had a drawing for a free iPad!

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!

Tags: Allscripts, Allscripts Consultants, Allscripts Enterprise EHR

What a week!  As with returning from any trip to Las Vegas, it seems to take forever to settle back in to the normal routine.  This time it seems that the “magic”, however you want to define it, of Las Vegas was simply overshadowed by the excitement of ACE. 

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

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

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.

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

If there is anything that the Galen team enjoys, it is putting our heads together on a particularly challenging question or problem within Allscripts Enterprise EHR.  We are a group of people who love a problem that you can sink your teeth into, and when we develop solutions we love to share them with the user community.    We are thrilled to introduce a new program in this newsletter where we give our readers an opportunity to enhance the body of knowledge that we publish on our wiki by “Asking an expert.”

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!

Tags: Allscripts