Every year, clinicians manually enter billions of point-of-care test results (such as urinalysis and cholesterol tests), from paper printouts into electronic health records (EHR). This is a time-consuming process, as a single test result can contain a dozen different numerical values and units. Each data point is an opportunity for error. To solve this problem one of Allscripts Developer Program partners, Relaymed, researched the current methods used by clinicians and incorporated this information as part of its user-centered design process to create its own automated workflow. Unfortunately, when Relaymed researchers evaluated the manual methods for entering test results into the EHR at multiple organizations, they found it doesn’t always happen successfully. Relaymed Chief Executive Officer Neil Farish reports that his team of researchers found numerous issues, including a continuous printout of lab results left hanging from a device for more […]

0 comments

Guiding principles for EHR design: A 10-point checklist

  • Jeanne Armstrong, M.D.
  • 03/22/2016

As one of the clinical architects of Allscripts TouchWorks® EHR, I work hand in hand with our functional architect, product owners and user-centered design (UCD) experts. We work as a team on new designs to make sure we’re using best practices to improve usability. We developed the following guiding principles as a checklist to help us better focus our product development on what users need: 1. Let users do their work when and where they discover it needs to be done. Reduce the amount of unnecessary clicks to complete a workflow. Design navigation and workspaces to enable users to perform a wide variety of tasks, while tailoring them for the most frequently performed actions. Where possible, free cognitive resources with automation. 2. Acknowledge chaos. Consider users who perform tasks in chaotic work environments, where interruptions are expected. Make it easy […]

0 comments

United in safety: Making patient safety a top priority

  • Geoff Caplea, M.D., MBA
  • 03/15/2016

This week marks National Patient Safety Awareness Week, but in practice, Allscripts makes patient safety a priority all year. Everyone across the healthcare industry has a part to play in keeping patients safe from harm. Here are some recent examples of how Allscripts and clients are using technology effectively to keep patients safe: Improve electronic health record (EHR) usability with user-centered design (UCD) – A well-designed software solution can improve patient safety and clinician efficiency. This white paper reviews best practices and illustrate UCD concepts with examples from Allscripts electronic health records. Monitor patients in the hospital for faster, more effective treatment – Evidence-based clinical decision support, combined with 24/7 monitoring can help clinicians intervene quickly with appropriate treatment. For example, Allscripts SunriseTM clients have used technology to help defend against sepsis, eliminate common hospital-acquired infections and reduce C. diff […]

Drug-drug interaction (DDI) alerts are supposed to help clinicians reduce risk of prescribing medications that may result in adverse drug events. The adverse events reflect medications that, when prescribed together, can cause bad events and outcomes for patients. But it is well proven that “alert fatigue” does harm, and in this case, negatively impacts any favorable intents or efficacy of avoiding DDIs. Alert fatigue, including for DDIs, happens because of the onerous number of alerts considered low-value by clinicians and information overload, causing prescribers to override or ignore alerts as often as 98% of the time. Another reason for limited impact of DDI-related alerts is that, for some specialties, the prescribing of the drug combinations tagged as DDI risks are commonplace and already proven to be good, efficacious medication approaches – cardiology among the most frequent. The medical staff at […]

0 comments

Making a difference in The Diabetes Belt

  • Jeanne Armstrong, M.D.
  • 03/08/2016

The Mississippi Delta, a region in the American South along the Mississippi River, faces higher rates of diabetes than the rest of the United States. In fact, the Center for Disease Control has identified the area as part of “The Diabetes Belt,” where 11.7% of people have been diagnosed with diabetes, compared to outside the belt with only 8.5% of the population. The Delta Health Alliance (Stoneville, Mississippi, U.S.A.) shared how it is using Allscripts solutions to manage diabetes care for better clinical and financial outcomes in a recent case study and video: A lack of physicians in the Mississippi River Delta region can limit patients’ access to health care. Providers need solutions that can help identify and improve communication with at-risk patients. To help meet demand for proven technology, the Delta Health Alliance is a collaboration of 60 Federally […]

27 comments

Why EHR usability has fallen short

  • Ross Teague, Ph.D.
  • 03/07/2016

A recent article said that electronic health record (EHR) usability is poor because clinicians are not the ones who are designing the products: “Physicians and other clinician users of electronic health record systems commonly rate the products low on a usability scale, in large part because non-clinicians do the bulk of the work designing them.” But does usability really suffer because non-clinicians are designing Health IT solutions? When we look at other industries, we don’t see end users primarily responsible for the design of successful products. For example, accountants don’t design banking technology, and writers aren’t developing word-processing software. Why do products in other industries seem to be more reflective of users’ needs? For EHR usability to improve, do clinicians have to create and design the products, or is there another more impactful way for them to be involved? I […]

The Hospital for Sick Children (SickKids), affiliated with the University of Toronto, is the largest organization dedicated to improving children’s health in Canada. These clinicians provide the best in complex, specialized care for some of our country’s youngest patients. We’ve always been impressed by the compassionate team at SickKids, but perhaps never so much as when we collaborated with them to complete five successful Allscripts Sunrise™ activations in 2015. We recently spoke with Steven M. Schwartz, M.D., FRCPC, FAHA, who led the implementation of Sunrise™ Acute Care in the Cardiac Critical Care Unit (CCCU), about the effort. Describe your department and what prompted you to move to Sunrise. The Department of Critical Care Medicine at SickKids is responsible for both the Cardiac Critical Care Unit (CCCU) and the Paediatric Intensive Care Unit (PICU).  Between us, we have 41 beds to […]

Using Application Programming Interfaces (APIs) to exchange data with an electronic health record (EHR) is a good step toward better interoperability. Some of our clients are having early success in using Allscripts Open APIs with Allscripts Sunrise™ to integrate with other software and devices. Integrated Health Information Systems (IHiS), together with Eastern Health Alliance (EHA), started using Allscripts Open APIs with Sunrise in January 2016. NantHealth’s VitalsConX solution enables the capture of patient vitals (e.g., blood pressure readings, temperature) at the bedside. This product then calls the Allscripts API, which validates and saves the data directly to the Sunrise patient record, reducing the need for the nurse to log into the EHR. IHiS developed the system architecture to enable the systems’ connectivity from the server to the EHR. According to William Wong, Deputy Director of Clinical Systems, IHiS, “Using APIs […]

0 comments

Managing wait times in urgent care

  • Jeanne Armstrong, M.D.
  • 03/01/2016

Have you noticed more advertisements from your local emergency and urgent care centers, talking about shorter wait times? It’s because healthcare organizations recognize that wait times play a significant part in satisfaction rates for patients and clinicians. Monitoring a patient’s experience throughout the visit can be challenging, especially if an organization must manage resources across multiple sites. Sharp Rees-Stealy (San Diego, California, U.S.A.) uses Allscripts TouchWorks® EHR and the Patient Tracking Board to improve the patient’s experience across its five urgent care settings. Improving patient experience in Sharp Rees-Stealy urgent care settings Through a quality-improvement initiative featured in a recent case study, the organization focused on three areas: intake, radiology and discharge. By streamlining these processes, Sharp Rees-Stealy has become more efficient and significantly increased patient satisfaction scores. The solution provides greater visibility as patients move through urgent care departments. […]