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.
Galen Healthcare Solutions will be hosting a series of free webcasts covering the Allscripts EHR database and Allscripts Analytics application.
The purpose of the EHR webcasts is to give a detailed view into the underlying database schemas as well as useful queries for the Patient and Order/Results tables. For Analytics we will be covering a basic overview of the Analytics applications as well as detailed examples using Worksheets and Crosstabs.
These will be structured in a similar format to university courses – the three classes will be at 100 (intro) levels. The list of the webcasts and their times may be found below.
Allscripts EHR – Patient: Overview of the Patient tables as they relate to the Allscripts EHR Database. This course will cover basic concepts related to Patient tables, as well as useful queries, views and general best practice techniques.
Allscripts EHR – Order/Results: Overview of the Order/Results tables as they relate to the Allscripts EHR Database. This course will cover basic concepts related to Order/Results tables, as well as useful queries, views and general best practice techniques.
Allscripts Analytics: Overview of the Allscipts Analytics application. This course will cover basic concepts related to general functionality of the Allcripts Analytics applications, including example Worksheet and Crosstab problems as well as general best practice techniques.
To attend, please contact Dave Boerner, Dave.Boerner@galenhealthcare.com . You must be an existing Allscripts Enterprise EHR client to attend.
We also offer training courses and reporting services for the Allscripts Enterprise EHR database, ETL database, Analytics and the ConnectR database. Please contact sales@galenhealthcare.com for more information regarding these courses and our reporting services.
We here at Galen have seen a greater influx of requests to be able to integrate client’s EHR environments with 3rd party applications and/or internet websites.
I’ve created a few examples that I’ve added to our Wiki page.
1. http://wiki.galenhealthcare.com/Patient_Portal_Integration
With this case study Galen had a client who has implemented a patient portal application whereby patients are able to send messages to their doctors regarding tests, results and general questions. The client was looking for a way to have the provider be able to integrate this application directly into the EHR. With RelayHealth’s help we have succesfully built a prototype whereby a provider can seamlessly communicate with a patient in the most efficient manner possible!
2. http://wiki.galenhealthcare.com/images/5/57/Add_new_Web_framework_documents_to_the_EHR.pdf
In this example a client was looking for a new link on their vertical toolbar which would allow them to display any website in their current workspace (the main viewing pane of the EHR). This one example integrates the website directly into the EHR window without having to navigate through a new tab or window, showing a FRAX calculator. The other tab actually has the ability to take in patient context (height, weight, blood pressure, etc.) and pass it into a form automatically populating fields to save physicians valuable time. This article goes through the steps involved in setting up new vertical toolbars, horizontal toolbars, and workspaces to set up these outside websites in the EHR. The actual code to populate patient context is fairly complex but definitely something Galen would love to help out with!
One of the many challenges in interfacing to the Electronic Healthcare Record is patient identification and matching. Results and documents from outside systems need to link to the correct patient record. This is especially profound in data conversion initiatives. Given the scenario of an organization converting to utilize an EHR, aside from the plethora of documents being scanned in and associated with the chart as well as “bulk loads” from the practice management system, there are could also be several data silos which need to feed data into the EHR.
We encountered one such scenario with one of our clients. Our client had been processing and loading flat-files from its legacy systems into the EHR. The client loaded approximately 15 years of legacy data (equating to millions of records). In the import process, the client had followed a strict patient matching criteria and received a patient matching error rate of approximately 5% which may be considered a reasonable matching rate.
However, the client’s help desk was getting a multitude of calls reporting missing legacy system records in the EHR (suspected to be in the 5% that did not make the conversion). The issue working against the client was a drop-dead date upon which these legacy systems were being deprecated and thus the clinicians would no-longer have a “fall-back” plan to access the records – the repercussions of which were potential patient care issues.
As such, Galen was engaged to analyze the records that did not meet the strict patient matching criteria , determine which records could be successfully loaded to the EHR under relaxed patient matching rules, and describe the impact of relaxing the patient matching. In the analysis that followed, it was recognized that in the data set that erred due to patient matching errors, identifier fields (namely first name, last name, DOB, MRN, Other Number1 and Other Number2) exhibited typos and inconsistencies. Enter Microsoft SQL Server Integration Studio’s (SSIS) Fuzzy Lookup Transformation. For those unfamiliar with fuzzy logic, it is “the process of reaching conclusions based on information and facts that are not 100 percent certain.”
The underlying algorithm to the Fuzzy Matching transformation is the SOUNDEX function:
• In the late nineteenth century, United States census officials faced a dilemma. During the process of counting the huddled masses, our public servants created a huge paperwork trail that the law required them to preserve for future historians. With amazing forethought, they realized that people searching for records might not know the exact spelling of their ancestor’s name. Was it Smith or Smythe? Chapple, Chapel or Chapelle?
• To ease these searches, census officials turned to the Soundex phonetic filing system. This system uses a simple phonetic algorithm to reduce each name to a four character alphanumeric code. The first letter of the code corresponds to the first letter of the last name. The remainder of the code consists of three digits derived from the syllables of the word.
• Largely unused outside of the halls of government and genealogy, the Soundex system is making a comeback in modern databases. Database developers have long struggled with the problem of matching words that might not look alike, but actually sound alike.
Thus to reclaim some of the records that erred in matching to a patient chart in the EHR, the Fuzzy Matching transformation was utilized. Flat-files output from legacy data silos were input, pre-processed and then fed to the transformation. Given previous studies, the matching criterion utilized was as follows: Match on LastName and FirstName Similarity Threshold >.8 AND DOB matches exactly AND one of three (MRN, OtherNumber, OtherNumber2) cross-referenced match exactly. The end result was reclamation of close to 25% of those legacy system patient records that originally failed patient matching.
If your organization is looking for assistance in data conversion, please contact sales@galenhealthcare.com and visit our website for more information regarding our technical service offerings.
The requests for reports that we get runs the gamut. Most of the time, clients are looking to modify the existing canned reports that Allscripts offers with the Allscripts Enterprise Electronic Health Record (AE-EHR). Other times, clients envision a custom report that is unlike any of those currently offered and is unique to their particular organization. And still further, some organizations wish to fulfill reporting metrics to receive monetary incentives from initiatives such as the Physician Quality Reporting Initiatives (PQRI) and P4P (Pay for Performance) . Given the commonalities in the requests we receive, with our reporting solutions store, we have attempted to pick the most popular reports requested from clients and offer them via on-demand payment, download and installation.
We also receive a substantial amount of inquiries from clients as to what exactly goes into customizing existing reports and creating new reports. Clients are often curious as to what types of skill sets are needed. These organizations may feel that they are better suited to have their own personnel develop custom reports. For instance, the organization may have performed an return on investment (ROI) analysis and determined it makes the most financial sense to train their own staff to supply the multitude of administrative and “print” reports they require in the coming future.
That said, let’s get to answering the question of what goes into developing custom reports for the AE-EHR:
The most important ingredient to custom AE-EHR report recipes comes in the experience – specifically knowledge of the database schema. Knowing what tables to pull from, how tables are related, and what functions, stored procedures and existing custom reports can be utilized so as to not re-invent the wheel. Knowledge of advanced SQL querying is invaluable as well. If you would like to learn more, Galen is offering free EHR Reporting webcasts.
Let us know if we may assist your organization in developing and delivering custom AE-EHR reports. In addition to the reporting solutions store, we also offer training courses and reporting services for the Allscripts Enterprise EHR database, ETL database, Analytics and the ConnectR database. Please contact sales@galenhealthcare.com for more information regarding these courses and our reporting services.
EHR Implementation