“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 firstname.lastname@example.org.