Archive for the tag 'Reporting'

Custom Reporting

“Allscripts TouchWorks is a great EHR, but is lacking in reporting.”  This sentiment has been expressed over and over by the people who use it daily. There are a thousand and one reports needed to deal with the wide variety of measures, and the differences between the reports can be subtle enough that a single canned report won’t cover many scenarios.

When it comes down to it, the EHR is meant to assist in the delivery of care; reporting, while useful, is a secondary consideration. That’s not to say that reports shouldn’t be included in the EHR, because a lot of value can be derived from them. They are useful in a multitude of ways, from simple reports such as problem-based patient populations, to reports on scheduled appointments or charges. Still, reporting often requires a finer level of detail than a canned product can provide, and even input parameters may not allow for that necessary level of control. Often, small differences in workflows cause data to be found in different fields, making out-of-the-box reports less practical. As requirements evolve, the complexity of even a simple report can multiply, and the reporting logic should have the adaptability to accommodate these changes.

In today’s data-centric environment, custom reports are incredibly useful in tracking progress on both external measures, such as HEDIS or PQRS, and internal organizational initiatives. There have been many variations of referral reports, such as the one Acton Medical Associates uses to analyze their internal vs. external referrals. Sunny Herguth, the Clinical Director at Acton, had this to say about their report:

The referral tracking report is used all the time to track referral trends and to use to see who we do not receive reports back from once a patients sees a specialist.

This is a great example of a custom report used for internal purposes. Knowing where referrals are going, and from which providers, can give an organization insight into areas that might be improved.

Another example, from OrthoVirginia, addressed the issue of providers not signing notes. Rhonda Coor, COO, explains how they use the report:

When my group decided to more closely monitor the signing of notes, I turned to Galen to write a custom report so I could track my physicians’ compliance.  The report is the only way I can stay on top on how the physicians are timely dictating and signing their notes.

This particular report was used to guide providers to complete their charting, though other reports have been used as a carrot rather than a stick incentive.

Custom reporting also contributed to the American Medical Group Association’s (AMGA) Measure Up/Pressure Down program, an initiative to improve hypertension patient care and the general health of this patient population. Rather than a regularly run EHR report, this report was designed to pull percentages of patients who met certain blood pressure criteria. Baptist Medical Group collaborated with Galen on the necessary parameters for the patient groups, and Galen developed several queries to extract and compile this data. The AMGA and Baptist leveraged the data to deliver better care to their hypertension patients, with the end goal of building a healthier patient population and reducing healthcare costs for the organization.

I’d like to conclude with an anecdote from Tom Goodwin, manager of Clinical Systems and Clinical Data Quality at MIT Medical:

In this electronic age it is hard to tell an exciting story about a printed sheet of paper. But if the sheet of paper serves as many purposes as I am about to describe I think you would agree that it is at least worth a smile.

In order to provide a high level of service, MIT Medical, like every other healthcare organization, needs to collect a tremendous amount of information from our patients. This information feeds billing, supports Meaningful Use and Joint Commission initiatives, ensures patient safety, and most importantly helps to improve the patient clinician relationship.

The MIT Medication Worksheet is unique to the presenting patient and can be printed from the schedule in a batch for the day or on the fly from a number of spots within the chart. Based on information we already have in our electronic health record, the patient is asked to verify standard demographic information, to support Meaningful Use they are asked to verify race, ethnicity, preferred language, their smoking status, and if they would like a clinical summary. For Joint Commission they are asked about special needs. For safety they are asked to verify existing allergies, the medication list as displayed in the electronic health record, and they are asked to write down any medications prescribed by an outside clinicians as well as over the counter or herbal medications that are taken on a regular basis.

Using this worksheet gives our patients a sense of how well we know them. They are more active participants in the care they receive and they aren’t frustrated by being asked to newly produce the same information at each visit.

Our friends at Galen Healthcare helped to make this and many other enhancements to our electronic health system possible. We truly value our partnership with Galen.

Custom reports can provide tremendous value. They can expose workflow deficiencies, assist in clinical and administrative decision making, and provide necessary data to third parties for patient care or financial reimbursement. Let Galen help your organization make better use of your EHR data. For further information, please check out a sampling of custom reports on our website or contact sales@galenhealthcare.com.

Client Success Story: Custom Problem Cleanup Solution at MIT Medical

Basic CMYK

Recently, Galen assisted MIT Medical with a Custom Problem Cleanup Solution. Tom Goodwin, Manager of Clinical Systems and Data Quality at MIT Medical Department had the following to say about his experience working with Galen to create this solution:

“MIT Medical is preparing for ICD-10 and at the same time trying to make the Allscripts TouchWorks™ problem list more dynamic and more of a reflection of the patient’s current health state.  Like many organizations, problems on the problem list were growing like weeds and were long overdue to be trimmed back.  Specifically, acute illness problems such as acute pharyngitis, acute bronchitis and v codes used for billing were in many cases not being resolved or suppressed.  So, as a morale booster, MIT Medical decided to engage Galen to help get a fresh start.  [Galen] wrote a script that cleaned up these problems if they persisted on the problem list for over 2 months.  If there was a description, impression, or annotation they were resolved and moved to past medical history otherwise they were resolved and suppressed.  This really helped MIT clinicians get the problem lists under control.  They could spend less time resolving items that clearly were no longer relevant so that they could focus more on documenting details about more important chronic illnesses.”

We really enjoyed working with MIT on this custom solution and are happy to be able to offer this solution to clients that are facing similar challenges with their problem lists.

Please visit the custom solutions section of our website to see the different types of solutions that we offer. Any of the solutions can be customized to fit your organization’s needs, and if you have an idea for a customization that you would like to implement at your organization, we are happy to work with you to create a new solution.

To see demos of the cleanup solutions we currently offer, please visit our Wiki to see the slide deck of a recent webcast. You can also request a recording, or discuss any of the solutions with Galen by contacting sales@galenhealthcare.com

Analytical ACOs, the next Dot-com bubble… ?

In the mid to late 90’s, at the beginning of the Dot-com bubble, the World Wide Web was available to anyone as long as you had a computer and a dial-up connection.  If you had these, you had the necessary resources to get connected and were likely eagerly seeking new websites to explore.

Now, imagine you are providing healthcare services, and you have the following resources available to you to enhance your practice that you did not have 15 years ago:

With plenty of IT staff and government money, the next best step is to invest in a major analytical/data mining department. To be able to effectively use an ACO, there is a critical need for analytics or the use of “Big Data.” According to a report by IDC Health, advanced analytics is a top priority for participants in ACOs. The question I keep asking myself is; “Who is the first to the pie?” Insurers? Hospitals? Medicare?

When 40 hospitals and 30 health insurance companies, as well as interviews with industry experts and vendors were asked the different ways they were interested in using analytics:

  • 66% of survey respondents cited identifying at-risk patients;
  • 64% cited tracking clinical outcomes; and
  • 57% cited clinical decision-making at the point of care (Government Health IT, 3/15).

The difficult question that hospitals are faced with is how they can implement a sound, efficient analytics department. The first company to emerge that satisfies this need will benefit greatly from this opportunity. At this point, you may still be wondering what the Dot-com bubble has to do with analytical ACOs. The picture I’m trying to paint is the hospitals are the stockholders; the government is the venture capitalists, and the companies providing analytical tools are the web site companies. I think the ACO analytics market is very fragile right now because of immature or inexperienced buyers investing in a very green market. The lingering question out there is; where will you be when the bubble pops?

ACO bubble_Dollar

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.

dbM_logo_CMYK_tagline

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.

 

JARDOGS-LOGO

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.

 

 

Automatically Capture Charges from the Note

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I am currently working with Clark & Daughtrey Medical Group to solve a unique problem. The group, which boasts national accreditation in many of its specialties, is looking to report on PCMH measures in innovative ways. So we started a conversation on how we could help them reach their PCMH goals. We discovered that their payers are reimbursing them for performing various clinical assessments. To do this, they have custom charge codes that are manually entered into the practice management system based on a medical coder’s review of each note. The medical billing staff spends hours every day sifting through these notes and entering the charges based on pre-configured flags in the note. With over 800 patient visits every day, this task is tedious and costs the practice a lot of money.

They asked us if there was a way that we could help them report on certain items in their notes. Unfortunately the note data is not discrete like medications and problems. It is actually a complex document stored in a format known as XML.While XML is a structured language, the document is first compressed then stored as one long string of text in the database. This means that if you wanted to search through the note in the database you would first have to decompress the note and then scan through the entire document for an identifier that is specific to that note. That is a nightmare for any type of reporting!

After talking with the staff at Clark & Daughtrey Medical Group we realized that this entire process could be automated! Using Note Form Reporting, I have developed a way to identify the appropriate check-boxes in the note and automatically submit the charges to the EHR. If the level of service charge has already been processed, then the charge is automatically submitted to the practice management system; if the encounter level charge has not been submitted then the provider will see it in the Allscripts Enterprise application just like any other charge waiting to be submitted. Clark & Daughtrey Medical Group will no longer have to waste time and money searching these notes for charges, the possibility of human error will be reduced, and the charges will now appear in both in the practice management system and the EHR.

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