Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

As reported on EMR and HIPAA, CMS has made comments on the Meaningful Use Interim Final Rule public, providing an additive level of transparency and CMIO promptly provided a summary of the EHR comments. In light of the transparency CMS/HHC/ONC yields in regards to the Meaningful Use Interim Final Rule, we encourage members of the healthcare IT community to take full advantage of the comment period, which ends in less than a month from now. To encourage ongoing dialogue, we have published a Meaningful Use FAQ in which we anticipate aggregating questions that persist in the community and also encourage active participation. For instance, in a previous post, I pondered how meaningful use would be communicated.

Other items to note in regards to lingering questions surrounding Meaningful Use and ARRA as a whole:

• Dr. John Halamka also addressed the public comments on the Interim final rule on his blog post.
• Many questions persist surrounding interoperability standards, and as John over at EMR and EHR addressed on his blog post, the Healthcare Information Technology Standards Panel (HITSP) was recently extended to be operational until April 30th only. How will this impact communication of meaningful use from organization to the government?
• We recently updated our meaningful use matrix to include which functionality supporting MU measures are delivered in the Allscripts Enterprise EHR (AE-EHR). John at EMR and HIPAA is also collecting a number of the various matrixes that people have put together around the EMR meaningful use criteria

If your organization is looking for assistance in exhibiting meaningful use, please contact sales@galenhealthcare.com and visit our website for more information regarding our technical and professional service offerings.

Tags: Allscripts, Allscripts Consultants, Allscripts Enterprise EHR, ARRA 2009, EHR Implementation, Meaningful Use, Meaningful Use FAQ, Meaningful Use Matrix, Successful EHR Implementation

Downtime. The often daunting word has many different meanings and severity levels for every individual. Within health care organizations, almost every application and form of communication is electronic, save for the chart. Thanks in large part to the new Administration, that gap will be closing quickly. As we move towards a paperless environment of complete technological dependency, new challenges emerge that may threaten the accessibility of patients’ health records. While the merits of moving to an electronic atmosphere are recognized industry-wide, the assumption that the availability of health records are 100% guaranteed is an unrealistic and potentially dangerous notion. What guarantee do physicians, nurses and clinical staff have that promises constant, uninterrupted access to clinical information? What access will they have should the system become unavailable?

Imagine in the middle of the night, an air-conditioning unit blows a circuit and consequently causes a dramatic rise in the core temperature of the server room. At over 100 degrees, the servers that haven’t already shut themselves down automatically are shut down manually, rendering all systems temporarily inaccessible. We have undoubtedly all experienced, at one time or another, email failure and while frustrating, the unwelcome disruption by no means prevents us from doing our job. Now couple this email outage with a clinical system that is down for an extended period of time. Finally, imagine the organization is an oncology group with patients scheduled for infusion, follow-up appointments, labs pending review, etc. In this case and most clinical care scenarios, it would be next to impossible to make a safe and well-informed clinical judgment. Luckily, in the true-life scenario painted above, the implementation was mid-stream so paper charts were still available. Despite their good fortune, this eye-opening incident caused the organization to scrutinize what downtime procedures they have in place if the EHR application goes down again.

It seems almost unfathomable that this issue has not been seriously addressed in any extensive manner. Some EHR vendors have tried to address the issue but most have not. With that said, this isn’t necessarily a bad thing; most would probably agree that they would rather have their vendor focused primarily on EHR functionality, expanded features, interoperability and other client needs. Some vendors have gone so far as to try and create a complete “working” application at the local site. Why create complexity in a scenario where access, particularly quick and painless access, is the only key requirement for clinicians?

We decided it was time to address this critical problem by creating a downtime solution, VitalCenter, which allows access to clinical data in any circumstance. In developing this solution we sought to account for all scenarios—server failure, LAN/WAN outage, application slowdown—not just extreme situations as in the previous example as well as a tool to assist with planned downtime, like upgrades. Every user will have a different threshold for what he or she considers ”unavailable.” Some will struggle through periods of intermittent slowness, while others will simply revert back to paper. Notably, VitalCenter can support a specific user in any unique situation.

At a high level, VitalCenter delivers patient charts, known as VitalCharts, to physician locations based on provider schedules. The access and delivery of this information is completely configurable by organization as well as per provider. For example, some providers may only require the previous Progress Note, while a specialist may require the most recent Note within the same specialty as well as the most recent Note. VitalCenter has the ability to incorporate such features. The application will extract patient data for a specified period of time going forward and in the past, again configurable to the individual needs of each physician.

We’re all in this together, and VitalCenter will provide a critical, albeit small, component to delivering patient care. VitalCenter allows everyone to focus on their job – clinicians continue to care for patients, administration ensures the organization is running smoothly and IT continues to work with its vendors to provide valuable and more reliable solutions to the organization.
VitalCenter removes the distraction that unmitigated downtime creates, and allows your organization to focus on what’s important – providing patient care.

For more information, please visit: http://vitalcenter.galenhealthcare.com

Tags: Allscripts Enterprise EHR, ARRA 2009, EHR Implementation, VitalCenter

Many American citizens hold fast to the concept of limited government, compact and accountable. When the new administration proposed a massive new spending plan intended to rescue a recessing economy, there was much debate over the nature and magnitude of the expenditures as funded by the taxpayer. With a keynote portion of the money designated to stimulate the medical informatics industry we are a part of, some are forced to reconcile their core principles with the genuine pursuit of real innovation. After much thought on this position, here is a line of reasoning I believe answers the critique:

1. There is broad consensus that a critical role of government is to coordinate public infrastructure projects that promote the common welfare.
2. The private industry has done a brilliant job developing the technology and processes that give us the health informatics capabilities that noticeably improve patient care and deliver information management and integration into the 21^st century.
3. Despite the success of some RHIOs, the private industry has been unable to develop the national standard; key challenges being the ability to account for and audit the utter mass of data, resistance to the general concept of information sharing, and of course, the high cost.
4. In the same nature as the roads, public works, and communication grids we all rely on, I would argue that the strategic management of critical data that serves the public good would constitute a “digital infrastructure”.
5. If nationally integrated health records were left to the private market with no central standardization, a successful implementation would take years.
6. A central organization with limited conflict of interest is capable of establishing the necessary standards of integration, metrics and quality. Then the profit driven private enterprise has clear parameters from which to develop and implement at the ground level. That strikes me as a solid compromise, provided these three factors are monitored:
   • The standards should not be heavy-handed, but rather firm, concise & measurable
   • HIPAA standards be maintained and private information be guarded from government inquiry
   • The private market continues to be the drivers of the technological advancement as the government incentivizes its adoption by the healthcare community

The technology platform is there. The common benefits are clear. The cost of entry is steep.

With those factors established, this $19+ billion passed for nationwide EHR integration will be a landmark investment in the future of our new national digital infrastructure.

Tags: ARRA 2009, Utilization