Precision medicine is a game changer for patients and caregivers. It enables clinicians to personalize care plans and treatment protocols for each individual patient, and not take a one-size-fits-all approach. One of the next big opportunities for healthcare technology is to find ways to apply genomic and proteomic information to improve patient care. Even though the human genome project concluded about 14 years ago, we’re still not using broad-scale, genomic-based decisions and protocols in health care today. Why not? Because genome sequencing has traditionally been expensive, incomplete and time-consuming.  Perhaps the biggest problem for clinicians was deriving meaning from about 3 billion base pairs of proteins found in the human genome. In addition, that meaning, once derived, has not been available to them in their clinical workflows. But that’s changing, thanks to significant advances in technology and computing power, which [...]

Fraser Health Authority (Surrey, British Columbia, Canada) uses Allscripts dbMotion™ Solution to make all relevant clinical information from multiple source systems available at the point of care. A recent case study shares how Fraser Health is currently using dbMotion to exchange information across its continuum of care from acute to community settings. It will expand interoperability to the ambulatory setting in 2015, with the integration of data from clinical systems supporting community care. At that point, more than 2,600 physicians in British Columbia will be able to view and exchange interconnected patient data without leaving their home clinical system, which will enable Fraser Health to better coordinate care for its patients and reduce duplicative services. In its first phase of dbMotion implementation, Fraser Health enabled 100 early adopters to have access to the system in December 2014. “Our early adopters [...]

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ICD-10: Tips for heading into the home stretch

Hospitals and physician practices have been discussing ICD-10 for many years. However, even with a one-year implementation delay, many of them are only now realizing that they are still not ready for the October 1 start date. In the past month, our ICD-10 consulting practice has received more inquiries for assistance than in the past calendar quarter. We expect this pace will continue well into the coming months leading up to October. A significant number of inquiries have come from organizations that have considered ICD-10 to be an IT or HIM issue. In fact, when looking at the scope within a hospital or practice that ICD-10 encompasses, there are more than a dozen areas that should be involved, such as revenue cycle and contingency planning. Ignoring any of these areas can have a detrimental effect on ICD-10 readiness. 3 most [...]

Until now, the delivery of health care has in many respects focused on treating the “average” patient. But individually, there is no average patient. Every patient is different. To individualize treatment, we need the ability to use genetic data to avoid medications that are known to be ineffective for the patient or are likely to cause adverse side effects. We need the ability to individualize preventative screening of patients. We need a tool that can be delivered easily to physicians, and be available to patients. It needs to both educate and provide decision support. Allscripts June App of the Month, ActX, uses advances in genomics to offer such a tool for Allscripts TouchWorks® EHR and Allscripts Professional EHR™. Precision medicine includes the use of genomic and molecular data to better target healthcare treatments, and learn the pre-dispositions to a particular [...]

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How to avoid “alert fatigue”

  • Steven Shaha, Ph.D., DBA
  • 06/11/2015

Some of us remember the old days and the art of tuning a radio. We finely adjusted the dials as we approached channels to get a clear signal, filtering out all the static and noise. The classic case of optimizing the signal-to-noise ratio. The art of optimizing our signal-to-noise ratio is alive and well when it comes to electronic health record (EHR) alerts. It’s important that alerts are relevant and meaningful to clinicians, or we run the risk of too much information becoming just noise. That’s the near-perfect definition of what we’ve come to refer to as “alert fatigue” among clinicians, which can be hazardous for everyone involved. Meaningful alerts help improve clinical results Here’s an example of how an organization not only optimized the signal-to-noise ratio, but conquered alert fatigue and improved clinical results. And all by addressing alerts [...]

In Taoist philosophy, yin and yang describe two seemingly contrary halves that together make a complete whole. It aptly describes a common experience in academic medical centers: Balancing patient care with academic training and research. At a recent advisory group meeting for Allscripts EPSiTM decision support leaders at academic medical centers, I heard some common themes: When a resident and physician are working side by side, how do we account for the expenses associated with teaching time and other “non-billable” activities? What are the true costs and contribution to patient care given the additional academic time and materials supporting each resident? How do we accurately budget and account for funding sources that are established to pay for the research and teaching aspects of care? How do we have the right financial incentives and programs in place to keep and grow [...]

Sharing crucial information across care settings throughout a care-community is increasingly mission-critical, especially in the unpredictable world of obstetrics and deliveries. Hospital Labor and Delivery (L&D) departments endure dramatic volume fluctuations and many opportunities for complications, all generally unanticipated even though expected. Meanwhile, clinics and obstetricians routinely see and assess prenatal patients, capturing data from delivery dates to risks, then again the same women postpartum, now with their infants. However, clinicians in these two interdependent settings generally share NO data, causing re-assessments or re-documentations on both ends, and compromising capabilities to perceive and meet risk-related needs. After investing in Allscripts SunriseTM as its interoperable electronic health record system (EHR), one organization demonstrated the value of care coordination for mothers and infants. Clinicians and information technology (IT) professionals teamed up to fine-tune applications to their local needs and to create ideal [...]

Whether I’m checking off things from my to-do list, like vaccinations for my kids, or trying to see my doctor when I’m ill, sooner is better. The most effective way for physicians’ offices to reach me is through a text letting me know when there’s an earlier opening. That’s why, as a patient, I love the ease and convenience of the Allscripts Developer Program May App of the Month from QueueDr. How QueueDr fills cancelled appointments QueueDr runs in the background of the practice’s Allscripts TouchWorks® EHR or Allscripts Practice Management™ solutions, knows when an appointment cancellation occurs, and texts the ideal patients already on the provider’s schedule to fill the spot. The first patient to text back the special word gets the earlier appointment. It’s convenient for both the patients and the practice. QueueDr helps the average provider see 10 additional [...]

Central Line Associated Blood Stream Infection (CLABSI)* is one of the most deadly hospital-acquired infections in the U.S. with a mortality rate of 12% – 25%. CLABSI can add up to 20 days to a patient’s hospital stay and carry additional healthcare costs estimated at $16,550 per case. Proven prevention techniques can reduce CLABSI incidence by 65% – 70%. Health First (Rockledge, Florida, U.S.A.) and Blessing Hospital (Quincy, Illinois, U.S.A.) shared in a recent client webinar how they are using Allscripts SunriseTM and best practices to decrease CLABSI. Blessing Intensive Care Unit (ICU) has had zero CLABSI cases in 3 years Blessing ICU Nurse Manager Kim Buck, RN, described how her organization uses Sunrise to guide clinicians through best-practice central line protocols. “Monitoring and charting patients through Allscripts Sunrise has contributed to our ability to have zero infections,” she said. [...]

The scramble to keep up with a rapidly evolving industry is taking its toll on physician practices. Regulatory compliance requires a lot of rigor on multiple fronts, including Meaningful Use, Physician Quality Reporting System (PQRS), Patient-Centered Medical Home (PCMH) and electronic prescription of controlled substances (EPCS). These requirements and others are causing general fatigue. For example, according to the Top 15 challenges facing physicians in 2015, about eight out of 10 physicians feel they are overextended or working at full capacity, and 70% report that they spend more than one day on paperwork each week. Unfortunately, there are hidden costs to this exhaustion that many practices overlook. Burnout can lead to leaving money on the table Physician practices have become almost desensitized to the worry associated with regulatory requirements. For example, ICD-10 is coming down the path, but it’s not [...]