Galen Healthcare Solutions: Allscripts Consultants Enterprise EHR

How do you create a manual for an application that requires fluid knowledge? The information of today may be changed by tomorrow’s hot fix, or next year’s upgrade. Knowledge about how people are using the system informs how we work to support them, their TouchWorks Allscripts Enterprise EHR system and their technical environment. Consultants to the Healthcare Industry must be more than just experts, they must be collaborators and partners with their client base in order to create the best and most robust systems for their clients and further the goals of better, higher quality medical care.

The Wiki is a tool that helps us to do just that. It is not a knowledgebase or SharePoint full of static articles that will be outdated tomorrow, but a dynamic and robust resource that can easily be updated to reflect the information that is current today. The Wiki is not “our” proprietary information. It is a collaboration between Galen employees and the greater EHR community (primarily Allscripts users right now)

Our knowledge and skills are constantly enhanced by the creative problem solving that we encounter as we work with our client base to develop systems that support physicians providing the best care to their patients. The Wiki is a tool that can keep up with the pace of information and innovation as we move forward. The name “Wiki” comes from the Hawaiian word “Wiki – Wiki” meaning fast.

Galen has been using the Wiki to publish answers to upgrade related questions as they are asked. Other collaborators can then see the information instantly (and are alerted in their outlook if they subscribe to the RSS feed) and can add any additional information that may be helpful.

Clients often come to us with real practical knowledge of their experiences with EHR and great stories of innovation that could be helpful to other product users. The Galen wiki is a place where users can have a platform to share their stories of how they made their system work for them and share suggestions with others. There are also talk pages connected to each article, so if a user has a question that they would like answered they could enter that into a discussion page connected to an article in order to get some additional information.

http://wiki.galenhealthcare.com

M. Maxwell Henson-Stroud, MSW

Upgrade Consultant

Tags: Allscripts Enterprise EHR, EHR, TouchWorks

I’ve spent the past year working with a health system that is taking advantage of the recent Stark exception and Anti-Kickback statutes and has donated the TouchWorks EHR to private physicians in the community. The health system, made up of two hospitals and a multi-specialty medical group, seized the opportunity to connect the community and help small, independent practices adopt an EHR.

In contrast to a traditional ASP or hosted model, this is a community health record where each provider along the continuum of care works exclusively from a fully shared patient record, updates the same medication list, allergy list and problem list. Instead of mailing a consult note, an independent physician can send a task to the referring provider at the host health system to review details of the visit. Coordinating a surgical procedure, a process that could take over 2 weeks in the pre-connected world, now happens in less than an hour as the primary care physician from the Medical Group and private specialist use tasking to communicate in the context of the patient record.

For more info click here

Tags: EHR, HIE, RHIO, TouchWorks

Panel Query in TouchWorks promised to make all the clinical data accessible to the everyday provider. Anyone could just pop into Panel Query, write a “query” based on an easy-to-use interface. No need to know SQL or any programming. And to protect the system, the queries were to be scheduled, presumably overnight.

TouchWorks largely delivered on this promise. Panel Query certainly delivered on the first part – anyone who is already using TouchWorks, can easily build usable reports with no technical/SQL background. Panel Query does not make every piece of information available, but it’s a great start. The problem lies in the execution of the query. First there is the performance aspect (Panel Query can really be a drag on your TouchWorks system’s performance), you also need to schedule the report, then the results come back as a patient list, which can be difficult to work from.

Performance is enough of an issue for most TouchWorks clients, adding queries that hit the system hard definitely won’t help things! Most practices can allow queries to run during the night, but Panel Query doesn’t enforce this – it allows you to schedule queries whenever you’d like. Other practices, say those with 24/7 urgent care clinics, cannot afford to have queries running during the night.

I worked with a group recently who had a copy of their production TouchWorks database (refreshed regularly) on their data warehouse server. They came up with an idea — could TouchWorks be setup to overcome the issues they had with Panel Query. Could Panel Query:

1. Point to their data warehouse
2. Make the results available in an Excel spreadsheet
3. Execute immediately – take out the additional steps of creating a job and scheduling it.

We’ve done all three, now anyone with access to Panel Query, can run queries while they are logged in to their production TouchWorks system (Panel Query then re-points to the data warehouse) any time of day and get their results back immediately.

I bring it up as it was a fun project that I really enjoyed working on. That’s all. What other projects have you folks worked on? Any ideas for other projects like this that you haven’t done?

Tags: EHR, Technical, TouchWorks

We recently brought our first client live on the Community Health Record using a Stark-donated implementation of TouchWorks.

At one client, who is donating TouchWorks under the Stark exception, we’re using Citrix to present the EHR to the users. Because of the resource requirements for Dragon (2GB+ RAM), we’ve installed it locally on the client PC’s instead of on the Citrix server and are just using Citrix for the EHR.

Using Dragon directly in the EHR works ok, but the accuracy and consistency is better when using the dictation box. Unfortunately when using the EHR in Citrix and Dragon locally on the PC, the ‘Transfer’ button in the Dictation Box is not able to determine where in the application to put the dictated text. The Phillips SpeechMike can be configured to solve this problem of getting the dictated text from the Dictation Box into the TouchWorks application with minimal effort.

Configure the SpeechMike’s fast forward button so that the following commands are issued: – Ctrl-A, Ctrl-C, Tab, Tab, Enter

This selects the text from the dictation box, copies it to the clipboard, and then closes the dictation box.

So the entire work flow would be something like this:

• Press the ‘Insert Overwrites’ button on the microphone to bring up the dictation box
• Press the record button to dictate
• Press the fast forward button
• Click in the appropriate field in the EHR
• Using the microphone say “paste that”

Of course you can always dictate directly into TouchWorks, but the commands don’t seem to work as consistently as they do in the Dictation Box.

Thanks to Melissa Heath for the SpeechMike configuration.

Tags: Dragon, EHR, TouchWorks