Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

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

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

Issue:

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

Investigation:

Enter the ConnectR Toolbelt “Transaction Processing Time” report:

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

Findings:

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

Outcome:

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

Tags: Allscripts Enterprise EHR, Business Intelligence, ConnectR, ConnectR Toolbelt, Integration, Interfaces, Meaningful Use, SQL Server Reporting Services

Galen Healthcare Solutions is proud to announce that we will be continuing our popular series of free webcasts this fall related to Allscripts Enterprise EHR.   These Webcasts will cover topics including Analytics, Allscripts Enterprise EHR Note, Interfaces, Reports, Allscripts Enterprise EHR Orders, Tech System maintenance.

Learn more »

Tags: Allscripts, Enterprise Order, Galen Webcast Series, Integration, Interfaces, Meaningful Use, Technical

Recently, the Centers for Medicare and Medicaid Services issued the final rule concerning meaningful use of electronic health records looking to qualify for the government incentives intended to increase the implementation of EHRs in the American healthcare system. A collective sigh of relief could be heard in offices of organizations around the country who have been scrambling to try to develop a game plan to meet the requirements outlined in the interim final draft. The final rule was drafted with an eye towards concerns that the requirements in the interim final rule were unattainable. By breaking the requirements down into two sets, a “Core” set of 15 items that all must be implemented, and another “Menu” set of 10 additional items of which only 5 need to be implemented between 2011-2012, CMS has made the process of meeting the requirements appear attainable. The final rule presented by CMS provides a more manageable framework for implementation of the technologies and actually may provide an opportunity for the organizations implementing the electronic health records to get some meaningful use out of the this legislation.

Tags: Allscripts Enterprise EHR, EHR, Meaningful Use