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8 seconds or less: How physician input improved usability

  • Jeanne Armstrong, M.D.
  • 05/24/2016

Physician input is vital for good Health IT design. The only way we can continue to improve adoption, usability – and ultimately patient safety – is to engage users early, often and through all stages of software design. Involving users is one of the guiding principles of Allscripts’ user-centered design (UCD) process, the subject of a recent white paper. When building new products or improving existing solutions, we follow those best practices. Formative testing catches mistakes before it’s too late All too often, users don’t get a chance to weigh in until Health IT solutions are about to be released. But we take great care to conduct formative testing for our new features and solutions. This type of testing occurs with early versions of solutions, such as wireframes, sketches or prototypes. Designers hold one-on-one sessions with actual users. They provide […]

Technology is one of the biggest paradoxes in health care. On the clinical front, modern day technologies offer patients life-saving therapies and improvement in quality of life. But communication among providers has seen little evolution over the past decades, still relying on pagers, fax machines and paper printouts. So we shouldn’t be surprised by a recently published study that revealed preventable medical errors are the third leading cause of death after heart disease and cancer. The majority of medical errors are due to poor ability to effectively communicate as a team of providers about the patient’s health. These sobering statistics, coupled with the day-to-day struggle to deliver high-quality care with outdated care coordination tools, inspired a group of Harvard-trained physicians and engineers to join forces. Together, they created a unique mobile care coordination platform for the hospital setting, called Yosko. […]

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Saving children’s lives with data

Data and reports are unlikely tools for heroes. But the team at Texas Children’s Hospital (Houston, Texas, U.S.A.) is analyzing patient information and tracking clinical results to help improve care for vulnerable, critically ill children. A recent success story outlines some of the many ways Texas Children’s is using Allscripts EPSi™ to support clinical initiatives throughout the organization. One example of these efforts is helping infants who have difficulty swallowing. Better evaluation of babies with swallowing difficulty, to reduce risk of aspiration Children who do not swallow safely are at risk for feeding and respiratory problems. Unfortunately, the primary tool to assess swallowing disorders is invasive and its radiation may have long-term negative effects. Occupational therapists approached Senior Decision Support Analyst Mary Watson with a request to develop a way to identify infants at risk for aspiration. Using EPSi, Watson […]

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That moment a nurse never forgets

  • Kerry D. Bruning, RN, BSN, MBA
  • 05/05/2016

Every nurse has at least one eye-opening experience that changes them forever. One of mine happened in a pediatric oncology unit almost 20 years ago. I was taking care of a seven-year-old boy, Jack*, who was recovering from a bone marrow transplant. Weakened by intense radiology and chemotherapy treatments, he had been unresponsive for several days. Despite his illness, Jack was an optimist. He was raising money to buy a bicycle so he could ride home from the hospital one day. Jack made and sold buttons for 50 cents each to help reach his goal. When I was doing rounds one night, I dropped two quarters in the jar next to his bed and took a button. I pinned it to my scrubs and gave the jar a shake to let Jack know he was one step closer to that […]

Implementing electronic health records (EHR) is no easy task, but there are key lessons learned from successful implementations that can ensure success. Allscripts Sunrise™ clients have shared tips about how they’ve implemented EHR projects on time, on budget and with the outcomes they expected. Here are a few tips I’ve gleaned from clients who know best: 1  It all starts with strong leadership An EHR implementation requires a massive amount of change, which is never easy. But if the leadership team supports the project, it will be easier to motivate and align the team to the organization’s goals. Leaders at the highest level need to visibly and consistently reinforce the message that failure is not an option. 2. Focus on outcomes – Understand the WHY Driving change is much easier when clinicians understand “the why.”  It is critical to articulate […]

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Creating opportunities in clinical informatics education

  • Jennifer MacGregor
  • 04/28/2016

Sir William Osler, the Canadian physician frequently described as the Father of Modern Medicine, was an innovator in medical training. He created the first residency program for specialties and introduced bedside clinical training as part of physician education. He once said: Observe, record, tabulate, communicate. Use your five senses…Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert. Though Osler said this more than 100 years ago, the principles are still relevant today. Observe, record, tabulate, communicate – modern clinical informatics strives to help clinicians with all of these foundational aspects of medicine. Allscripts is working with world-class Canadian education organizations to create additional opportunities in this field. Partnering with Dalhousie University to improve healthcare IT education opportunities Dalhousie University is known for providing its researchers and students […]

Some time ago (i.e., 2008), the Centers for Medicare & Medicaid Services (CMS) implemented policies aimed at eliminating reimbursements for several “never events.” CMS estimated that avoidable adverse events and errors cost $300 million annually – not to mention unnecessary patient suffering – and so needed to end. High among the focal never events were falls, including falls with injuries, and decubitus or pressure ulcers (PUs), especially those of higher severity, risk and cost, Stage III or Stage IV. Yet no computer can turn a patient to avoid a pressure ulcer, nor catch a patient to avoid a fall. So how can a programmable electronic health record (EHR) make a difference? Conquest of pressure ulcers and falls is not simple, but can an EHR help? PUs are the second most common of the never events, estimated to occur for as […]

Today there are many steps to processing claims, and each one is an opportunity to gain or lose money. Practices are weighing the pros and cons of different approaches to managing their revenue cycle, including relying on experts from outside their organizations. Arbor Family Medicine (Westminster, Colorado, U.S.A.) Office Manager Mikie Gonzales talked about her experience with Allscripts Revenue Cycle Management Services™ (RCMS) in a recent interview: Gonzales discussed some of the myths that surround decisions to bring in a revenue cycle management services partner. Her experiences are similar to other clients and “bust” some of the most common myths: Myth #1 – We’ll lose control of our billing activities. As responsibility for claims – from submission to sorting out denials and beyond – shifts to a services partner, some practices fear that they are also giving up control. However, […]

In a recent Client Outcomes Collaboration Program webinar, Allscripts clients shared how they have used the LACE index to identify patients who are at risk for readmission. Based on what they’ve found, they’ve taken different approaches to intervening with their patient populations. What is LACE and how does it help prevent readmissions? The LACE index, designed to identify patients who are at risk for readmission or death within thirty days of discharge, is based on four factors: L – Length of stay A – Acuity of admission C – Co-morbidities E – Emergency room visits The higher a patient scores on this index, the higher the risk of returning to the hospital. Hospitals are beginning to use LACE as a tool to stratify patients based on their risk level and work to reduce unnecessary readmissions. Many healthcare systems are working […]

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EHR design requires user input, early and often

  • Ross Teague, Ph.D.
  • 04/07/2016

Adherence to user-centered design (UCD) best practices is key to improving electronic health record (EHR) usability. A recent white paper reviews UCD best practices, and how they help improve usability and patient safety. Unfortunately, many EHR vendors skip a crucial step in UCD: formative testing. In this phase, software designers test early versions of the technology with actual users. They’re not testing completed code or solutions ready for market, but rather prototypes, wireframes or even early sketches. Good formative testing is iterative, meaning designers must gather and address feedback from users several times before finalizing the software. To illustrate how the formative testing process works at Allscripts, here’s a recent example from our Allscripts Sunrise™ Ambulatory Care solution. Example: Formative testing for a new task module The Sunrise team conducted formative usability tests on a newly designed task module with […]