Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

The benefits of a results data exchange between a vendor system and the Electronic Healthcare Record (EHR) are profound, as the need for redundant and often erroneous data is greatly reduced. More importantly, by implementing a results data exchange to the EHR, providers are delivered more timely and accurate clinical data, yielding an increased level of patient care.

Benefits

• Elimination of redundant entry of patient data.
• Result reconciled to order automatically
• Immediate availability of the results to the enterprise.
• Decreased risk of patient matching errors (name misspellings, missing dates of birth, etc).
• Elimination of scanning of signed paper labs to the EHR.
• No more lost lab results.
• Run reporting on the data from labs in EHR (for example, blood sugar change over time).
• Automated result tasking as well as the ability to send copies to related providers, such as the referring provider or the patient’s primary care provider.
• Automated Tasking.
  • Verify result task.
  • Carbon Copy (Review result task).

  

• Automated synchronization of item dictionary.
• Drop a charge automatically to the PMS (assuming a charge data exchange is in place).
• Capability to automatically send insurance information to labs for lab direct client bill (assuming the insurance data exists in the EHR. This data is usually fed from a separate PMS data exchange).
• For PACs data exchanges, facilitates viewing of image result directly from EHR.
  

And perhaps the biggest benefit is that many groups are able to negotiate with their lab and radiology providers to subsidize the cost of the data exchange. Since the data exchange presents many benefits from their point-of-view, the lab and radiology providers are often happy to provide financial incentive for practices to participate in an electronic data exchange.

Return on Investment (ROI)

A three-hospital study conducted by LINK Medical and Philips Medical provides great insight into the return on investment that interfacing can provide. These hospitals analyzed and assessed the effectiveness of automating the process of Electrocardiogram (ECG) orders and test results, with the following realized outcomes:

• Reduction in direct annual labor costs ($11–25,000).
• Elimination of non-billable tests.
• Elimination of lost charges (1% to 2% of ordered tests).
• Short payback period (less than 12 months).
• On-going ROI – these savings and associated benefits continued.

Overall cost savings were in the range of $43,000 to $59,000 per annum.

Galen Healthcare Solutions: Interface Services

Tags: Custom Reports, EHR, Integration, Interfaces, Results Interface, Technical

Synching of results in Allscripts Enterprise EHR v11 has been both very appealing and difficult for many to understand.

The premise is this – if a patient has a test done over time, you would like to compare the results – in HMPs, flow sheets and result history.  If the lab changes the code used for a particular result (as is common), or you send the same tests to multiple labs (also common), you need a way to link those separate resultable entries for comparison.

Recently, we had the chance (a client of mine and I) to speak to some folks at Allscripts – their clinical architect and the product manager for Order.

We had two basic questions:

1. Should we synch our results?
2. If we don’t synch, then what?

Ultimately, we chose to use “Considered equivalent” mapping that will be fully functional in a later release – perhaps as soon as v11.1.7.

The details of our discussion should provide insight on the decision that we made.

Should we synch our results?
Ideally yes, the Resultable Item Dictionary (RID) should be setup similarly to the Orderable Item Dictionary (OID) – with one master RID entry representing any equivalent RID entry.  The more lab vendors you interface with, the more important synching becomes.  Synching will make your the HMP, flow sheets/grids, graphs, and historical results display on one consolidated line and look great.

The reality is, that over time, lab vendors will change resultable codes (INR from 1/1/08 – 8/30/08 = code 12345, from 9/1/08-12/31/08 the INR code = 56789).  Since you can only have one RID entry per Requested Performing Location you would have to go update the INR synching to use the 56789 code to represent new INR results.  This means that if you are looking historically at a patient that had a PT INR in March and a PT INR in December their INR results would display on two lines even with Results synching. (See grid below)

If we don’t synch, then what?
Allscripts is planning to use the “Considered equivalent only for flowsheet graph:” (which can be set up in the RID entry) to do basically the same thing as the synching, but this would allow you to synch as many resultables as you want together (not just one per result per requested performing location).  The plan is to have the “considered equivalent…” consolidate results in the HMP, flow sheets/grids, graphs, and historical results.  So, even though ideally right now synching will help you consolidate line items it looks like the need for it will be obsolete in the near future.

We’ve made the decision to go ahead and use the “Considered equivalent” setting and hold off on the results synching.  We hope that in the future all of our needs will be met with the equivalent mapping.

This is high level summary of the discussion that we had.  If anyone is contemplating synching and you have any questions or would like to discuss further, please leave a comment.

Tags: Allscripts Consultants, Allscripts Enterprise EHR, Results Interface, Successful EHR Implementation