Archive for the tag 'Meaningful Use'

HIE is here to stay

Galen Healthcare Solutions announced its strategic partnership with Orion Health in a past January article. Since then, Galen has been heavily involved in the recent boom of Health Information Exchange (HIE). What’s an HIE? In a nutshell, HIE is the “secure health data exchange between two or more authorized and consenting trading partners” (HIE Implications in Meaningful Use Stage 1 Requirements). On one end is the data supplier; on the other end is the data receiver. A third party – in this case, Orion Health – facilitates the data transfer to ensure quality control and necessary HL7 specifications.

I’ve spent the past few months working with two promininent HIE projects: hundreds of hospitals in each state sending demographic information, clinical documents, laboratory results, radiology reports, and immunizations to the state’s data repository. Providers from those hospitals are then able to access a portal that can display a patient’s full medical history from multiple hospitals on one profile.

Engaging in an HIE is one way for a hospital to meet Stage 1 Meaningful Use objectives. HIE engagement will only grow in the future as Stage 2 and Stage 3 Meaningful Use requirements are initiated. At its core, Meaningful Use is using EHR technology to promote patient engagement, care coordination, and health security. A breakdown of the 3 stages are as follows:

An important criteria for Stage 2 is that providers who have met Stage 1 for two or three years will need to meet meaningful use Stage 2 criteria to continue collecting government incentives. As eligible providers move into the next phase of meaningful EHR utilization, we can expect the trend of HIE to continue, with increased attention on advanced clinical procedures.

The Benefits of a Shared Community Record

Why would an independent practice or community clinic benefit from sharing an electronic record system with a larger organization? After all, they often view these organizations as their competition. They are private clinics for a reason. They want to make their own decisions. They want the flexibility of staffing who they want in what roles they deem appropriate. They want to keep their patient lists private. They value their independence.
So, just what are the benefits for a community clinic to join the EHR of the larger healthcare organization?

  • Continuity of patient care. Physicians have access to the patient’s history at the click of a mouse. The physician knows the patient’s history from experience; decisions and new information can be integrated from a whole-patient perspective efficiently without extensive investigation or record review.
  • Transparency of data. Clinical data can be shared freely while keeping finances and scheduling completely separate and private.
  • Improved referral process. The referral process is made more efficient and the results turn-around is much faster and more consistent.
  • Better communications between patients and providers. There are fewer chances for errors and “missed” communications, both provider-to-provider and provider-to-patient.
  • Centralized system maintenance and troubleshooting. Community providers benefit from sharing technical resources of the host organization, including support and upgrades.
  • More affordable cost option. Community physicians and hospitals can have all the benefits of a shared record, often at a lower cost than implementing a free-standing EHR.
  • Benefit from lessons learned from a completed implementation. The larger organization does all the work after having had a successful implementation. They have picked a meaningful use (MU) approved vendor, efficient and meaningful workflows have been tested and proven, and quality reports are already created and readily available. This avoids the risks and time consumed by starting from scratch.
  • Government financial incentives are theirs to keep. Meaningful Use dollars are their own.

Ultimately, joining a program such as Epic’s Community Connect gives these practices the access to share medical records with the larger organization in an easy, proven and affordable manner. Private clinics and community hospitals can maintain their independence while their access to a shared medical record contributes to better, safer patient care.

Integration Client Success Story: NMDOH -> NMSIIS Immunization Interface

Galen’s expertise and sound approach allowed our organization to achieve integration with the state registry. Their flexibility and ingenuity in facilitating necessary customizations combined with their wealth of knowledge with regard to standards was invaluable to the project. We highly recommend partnering with Galen in integration initiatives.
-Irene Vold, NMDOH BEHR Program Manager

Many health care providers are required by law to send their immunization records to the state registry. An immunization interface can assist healthcare providers with completing this task. Sometimes a standard immunization interface can work effectively, other times customization is needed. A client of Galen recently implemented an immunization interface to send their immunizations from their EHR to the state registry, NMSIIS (New Mexico Statewide Immunization Information System). This particular implementation required customization as the state registry only accepted weekly batch files and also required customization to scrub and filter transactions which did not meet requirements as outlined in the specification.

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Let My Data Go!

I recently had a nice chat with a colleague analyzing HIT industry trends for Kalorama Information. Kalorama does industry research for the medical and life sciences for many of the major news and consulting organizations. I got in touch with her specifically because of Kalorama’s analysis on EHRs in 2012 which was used by Bloomberg Government for their (very expensive) EHR industry analysis for provider and vendors. She found that in 2012 one of the most immediate challenges for providers was implementing EHR systems that meet meaningful use standards. She also found that vendors were having trouble with interoperability and usability.

Fast forward to 2013; a lot has changed. Epic has grown to dominate many markets. Allscripts has a new CEO and a few new toys to play with. eClinicalWorks has become a force to be reckoned with in the small practice space. However, the challenges the providers are facing have changed. My colleague and I talked for a while about various organizations we each have worked with and came to the same conclusion: providers are now having trouble with interoperability and conversions of data.

2013 Priorities

The majority of physician offices have implemented EHRs, but they must now communicate with other entities such as HIEs and ACOs. With the increase in mergers and acquisitions, we are also seeing an increased demand for conversions from one system to another. These problems involve a thorough understanding of the underlying data structure as well as a solid foundation in interoperability standards such as LOINC, HL7, SNOMED, and CDA. The vendors have the expertise to work on the problems for their products, but they are not enthusiastic about helping clients switch off their platform. Selling the EHR has been the primary goal for vendors in the past, not technical support that moves a client away from their product. Vendors are under the assumption that if they make switching off their product difficult, then clients will be less likely to undertake the conversion or integration with a product that is not part of the vendor’s family of products. While this is definitely true for disgruntled clients, it only makes it frustrating for clients who do not have a choice in the products they work with. This reality has led to some very important questions.

Where is an organization to go when their own vendor is not supporting their efforts? How do organizations extract meaningful data from such complicated or cloud based databases? How can we become self-sufficient in managing our data? How does an organization meet new institutional and government requirements? Galen can help clients with these challenges, but vendors need to help by making products that play nice with others.

At the end of our conversation my colleague and I simultaneously came to the same conclusion: “Organizations feel like their data is being held hostage!

Allscripts Strategic Acquisitions

A couple of weeks ago I wrote a blog post on the current trends in the EHR industry. I mentioned that users of Allscripts products have increasingly been switching away from Allscripts to other vendors. Either Paul Black at Allscripts is following this blog, or he looked at the Allscripts client list because he is looking to reverse that trend. On March 6th, Allscripts announced its acquisition of two companies dbMotion and Jardogs in an attempt to improve both their Allscripts product lines and to continue to enhance to the Allscripts community’s ability to share information openly. For those of you who may be worrying about Allscripts’s commitment to its own products, don’t fret! Concurrent with this acquisition, Allscripts has pledged over $500 million to improve its own product offerings. However, some of you may have never heard of either of these newly acquired companies, so I thought I would provide a brief overview of each acquisition.


Sold for $235 Million 

dbMotion was founded as an independent company in 2004 in Israel with a significant investment from the University of Pittsburgh which hoped that dbMotion could help solve some of its data interoperability needs. dbMotion lets healthcare companies take data from many different electronic records systems and normalize it to a common data structure That data normalization helps hospitals with business and clinical intelligence, and it lets patients access all their health data in one central location. Allscripts likely bought dbMotion because data analytics and open sharing of information is where the value and growth will be in healthcare now that most hospitals and physician groups have a core electronic record system in place.



Sold for undisclosed amount

Jardogsis a Springfield, IL based company that has seen use of its FollowMyHealth online health record grow to about 13,000 hospitals and other health-care providers nationwide. The cloud based FollowMyHealth solution, which Jardogs launched in January 2011, gives patients access to a single online portal in order to send and receive information to and from their doctors, hospitals and other health-care organizations. This means that patients can have immediate access to their medical records, including test results and doctors’ notes.  As a founding member of the CommonWell Health Alliance, Allscripts sees the Jardogs product line, specifically FollowMyHealth , as a promising opportunity for increased patient engagement which aligns with the Allscripts Open platform strategy.



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