Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the third in a three-part series that will address aspects of interoperability: 1) overcoming barriers 2) financial motivation and standards, and 3) information blocking. An important consideration for information liquidity are the physician practices (small and large) and independent hospitals that have been pressured to move off of their current Electronic Health Record (EHR) system – Allscripts in some cases – to one used by the large enterprise health system in their area. It’s called “data bullying” or “information blocking,” because one party isn’t committed to establishing connectivity between current systems and in some instances, will even put up indirect roadblocks. For example, sometimes larger health systems [...]

Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the second in a three-part series that will address aspects of interoperability: 1) overcoming barriers 2) financial motivation and standards, and 3) information blocking. The current payment system simply does not offer appropriate financial motivation for providers to create an interoperable healthcare environment; this is especially true given that the burden of cost falls to them almost exclusively. Healthcare providers are genuinely committed to providing the best care they can to patients, but the common reality of running on only a few days’ cash flow sometimes trumps loftier goals. Much as CMS policy has already had a marked impact on hospital readmission rates by associating them with [...]

Editor’s Note: On July 23, 2015 Paul Black testified before the Senate Committee on Health Education Labor and Pensions, to share his thoughts about how to advance health data exchange. This post is the first in a three-part series that will address aspects of interoperability: 1) overcoming barriers, 2) financial motivation and standards, and 3) information blocking. Interoperability is of great concern to us, as more independent doctors use our software to treat patients than any other commercially available product. If a stakeholder were to intentionally get in the way of information exchange, there are two main concerns: 1) it would be bad for patients, and 2) it could be anti-competitive. Period. Several years ago, Allscripts made a decision to invest in an Open approach to connectivity – one that is grounded in the Allscripts dbMotionTM Solution connectivity platform and [...]

In the midst of a busy day, it’s not always easy to call my doctor’s office to get advice or schedule an appointment. It’s even harder when I have to leave a message, and I’m in a meeting when the office calls back. Sometimes, it can take hours or even days to resolve the issue. Today’s patients expect more. The experience they have on those calls, and whether everything is resolved quickly and easily, affects their overall experience with a practice as much as interaction during in-person appointments. Through the Allscripts Developer Program, we provide lots of options to help providers connect with patients to help resolve patient questions, issues and needs as efficiently and effectively as possible. Health Desk, by Keona Health, is a tool that can help providers effectively engage with patients calling or asking for health advice [...]

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Kid-sized doses in an adult-sized world

  • Salman Naqvi, MD, MPH
  • 07/21/2015

When prescribing medications, physicians base it on the weight of the patient. Pediatricians are constantly scaling doses to fit their patients, increasing the risk of errors. To ensure patient safety, Phoenix Children’s Hospital (Phoenix, Arizona, U.S.A.) wanted to find an enhanced solution to Dose Range Checking (DRC) to help its clinicians during order entry. Phoenix Children’s Hospital Chief Medical Information Officer, Dr. Vinay Vaidya, M.D., shared more information in a recent Client Outcomes Collaboration Program webinar. The positive results were also published in an article in the Journal of Patient Safety. Phoenix Children’s had three goals for this project. First, given the importance of pediatric patient safety, it wanted to move quickly. Second, it wanted to take a phased approach, addressing high-risk, high-frequency medications first. And third, it was striving for zero prescribing errors. Unfortunately, there weren’t any commercially available, [...]

To compete in today’s value-based-care market, many physician practices give up their independence. Research commissioned by The Physicians Foundation found that only 35% of physicians describe themselves as independent practice owners, down from 49% in 2012 and 62% in 2008. But we find a different story at Family Practice Associates, one of the largest independent family practice groups in central Kentucky. How this practice remains competitive – while maintaining its independence – is the subject of a new video: The integrated suite of Allscripts Professional EHRTM, Allscripts Practice ManagementTM and Allscripts FollowMyHealth® patient portal helped the group earn $375,000 in Meaningful Use incentive payments, improve net collections to 98%, and enroll 20% of its patients in the portal in less than a year. “Family Practice Associates has always been a very independent organization and wants to remain that way,” Administrator [...]

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ICD-10 readiness: Will your coders have enough information?

  • Jeff Goldstein, MD, MS FACHE
  • 07/14/2015

User documentation, education and governance remain the top three issues threatening ICD-10 readiness. But another, equally disturbing practice is emerging. Many hospitals and practices have opted to let coding staff select ICD-10 codes based upon physician documentation, placing key decisions in the hands of the coders instead of clinicians. In a recent Healthcare Informatics article, Dr. John Elion noted that certain ICD-10 PCS (procedure coding system) codes require a great degree of detail and granularity. The physician must explicitly detail a procedure and the circumstances associated with the event so that there is no ambiguity as to the correct code. The real concern is not missing information, it is that the physician’s description is not formatted to meet the requirements of ICD-10. When this happens, then it is up to the coder, or clinical documentation improvement (CDI) specialist, to either [...]

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7 keys to success with clinical decision support

I realize and admit I have biases. One bias is that I believe the principle reason for the healthcare IT industry is to optimize patient-clinician interactions to heal and keep people healthy. Another bias is that without solid financials and organizational performance, everyone ultimately loses. My third bias: I believe clinicians whom we trust with our very lives, and IT experts, are trained professionals and should be trusted to optimize electronic health records (EHRs) as a local team. EHRs should provide solid clinical decision support (CDS) to help clinicians optimize patient decisions and interactions, and help organizations exceed performance goals. CDS puts clinicians at the forefront for deciding, coding, monitoring and updating.  Here are the seven most powerful CDS-focused EHR characteristics for assisting clinicians with their decisions and documentation: 1. Programmability Programmability ensures that hospitals can remain in sync with [...]

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 [...]