Bio: Douglas Gentile, MD, MBA, is Chief Medical Officer of Allscripts. Educated at Duke University, the Medical College of Wisconsin and Stanford University, where he received a master’s degree in business administration, Dr. Gentile has been influential in healthcare IT for decades. A former faculty member at Vanderbilt University in Emergency Medicine, and a leader within the Decision Support Group, he was a founding partner of The Crucible Group, a venture capital group focused on early stage healthcare companies, where he developed the business plans for Sharepoint and IPC, the Hospitalist Company, Inc. (Nasdaq: IPCM). Dr. Gentile later joined IDX Systems Corporation as part of ChannelHealth, which was acquired by Allscripts in 2000. At Allscripts, Dr. Gentile directs clinical product strategy. He is a member of AMIA, HIMSS and is on the steering committee for the Markle Foundation. Dr. Gentile continues to practice Emergency Medicine part time at Fletcher Allen, the main teaching hospital of the University of Vermont College of Medicine.
Posts by :
The ONC’s proposed rule for Electronic Health Record certification under Stage 2 Meaningful Use includes one requirement that will be good for clinicians and good for patients – the Infobutton. Under the rule, EHRs certified for Stage 2 would be required to support the HL7 Infobutton standard for two distinct use cases:
- Providing a context-sensitive link to reference information to support clinical decision making
- Providing links to patient-specific education resources
So what is an Infobutton? Infobuttons link an EHR to an outside knowledge source. Importantly, Infobuttons are context sensitive. For example, if the patient has a diagnosis of multiple sclerosis on his or her problem list, an Infobutton next to that problem would link the user to one or more knowledge sources about multiple sclerosis. The user can access the information immediately without opening a new application or web page, without logging in (log-in information is passed automatically to the knowledge source), and without needing to search the knowledge source.
The idea is to make it quick and easy to answer clinical questions. Studies have shown that physicians generate an average of two questions for every three patient encounters, and answering those questions is often significant for patient care. Today, those questions frequently go unanswered due to lack of time.
As a practicing emergency physician, I can tell you that there’s nothing worse than not knowing the answer to a critical question when you need it. Infobuttons like those within our Sunrise Clinical Manager are a practical means of generating quick answers to urgent clinical questions.
I want to commend ONC for including the Infobutton standard as part of Stage 2. Adoption of the Infobutton standard by both EHR vendors and content providers should have a measurable impact on improving clinical decisions and facilitating the delivery of timely and appropriate education materials for patients. We’re already seeing the impact of this decision as every content vendor we’ve talked to is moving rapidly to support the standard, along with Allscripts.
Our ability to meet the standard will enable our clients to choose both the reference sources and patient education sources that are most appropriate for their organizations, knowing that they can easily integrate them with their EHR using the Infobutton standard.
QUESTION: How do you feel about the proposed Infobutton requirement? If you’re a clinician, would it improve your practice?
Allscripts is taking a leading role in the delivery of best-practice care for patients with cardiovascular disease through sponsorship of the Allscripts Million Hearts Clinical Decision Support Challenge, which officially opens today.
The Allscripts Million Hearts Clinical Decision Support Challenge offers a $50,000 prize to the person or group that creates a publicly available clinical decision support (CDS) resource to accelerate the delivery of optimal treatment for cardiovascular disease. Our goal is to accomplish this by facilitating the translation of the resulting CDS rules into an unambiguous, machine-readable format that can be “read” by any Electronic Health Record (EHR). Allscripts will provide materials, including an XML format that participants can use in the development of the solution.
In line with our long-held commitment to interoperability and open systems, the Challenge is designed to make important elements of the winning solution available to the community and other EHR developers under an open source license. Our hope is that making the solution available under an open source license will encourage widespread adoption of a standardized Million Hearts Initiative CDS protocol which can be maintained and extended by the sponsor and other industry participants.
Contest terms and conditions are now available online.
Million Hearts™ is a national initiative announced last year by the U.S. Department of Health & Human Services (HHS) to prevent 1 million heart attacks and strokes over the next five years. Allscripts is one of several private-sector partners that is supporting Million Hearts™ through a wide range of activities.
We first announced the Allscripts Challenge at the CMS Care Innovations Summit in Washington D.C. on January 26.
Timing and Deadline Information
- Competition begins: March 26, 2012
- Competition Closes: July 13th, 2012
If you are interested in participating in the Million Hearts CDS Challenge, please Click Here to indicate your intent to participate and download several documents that may be useful in your work, including the XML schema being contributed by Allscripts to this effort.
For a gathering of healthcare professionals, HIMSS registers pretty low on the healthy scale. Consider how attendees rank on just one chronic disease: An estimated 43 percent, or 15,000, of the 35,000 attendees expected at HIMSS12 in Las Vegas this week either have diabetes or pre-diabetes.
Impossible, you say?
To be fair, 43 percent represents the proportion of Americans with diabetes or pre-diabetes, according to the CDC’s National Diabetes Fact Sheet. Presumably, the physicians, nurses and other healthcare professionals who attend HIMSS are better educated about diabetes than the average American, and less likely to be diabetic.
The point is, far too many people – whether at HIMSS or in living rooms across the US – fall prey to America’s most prevalent chronic disease. As a result, total direct and indirect costs of diabetes in the United States are $174 billion annually (2007 figures).
According to the CDC, improved glycemic control benefits people with either type 1 or type 2 diabetes. Every percentage point drop in HbA1c blood test results can reduce the risk of microvascular complications (eye, kidney, and nerve diseases) by 40 percent.
Today, Allscripts and MyCareTeam (MCT) announced a new national effort to make online monitoring and self-management of diabetes easier and more effective. A number of peer-reviewed studies have shown MyCareTeam’s remote diabetes care management solution reduces HbA1c levels by an average of 2 points (i.e. HbA1c from 10% to 8% after a year of management using MyCareTeam). This could translate to more than $8,200 in annual healthcare savings per patient.
By integrating the MyCareTeam solution into a providers’ daily Allscripts EHR workflow, patients can now easily share information on glucose levels, insulin dosage, diet and activity levels with their provider. This allows patients to collaborate with their diabetes care team from home as well as in the office to improve glycemic control and their overall health.
“This is a way that patients can download (their glucose levels) in the comfort of their homes, get that information sent right into their medical record, it comes right into our tasks, and we can look at that information and if there’s a problem, get back to them immediately,” says Diane Carter, RN, a nurse practitioner at UMass Memorial Healthcare in Worcester, MA, where over 2,700 patients currently use the Allscripts-MyCareTeam solution.
Or if you’re at HIMSS, see it yourself. I will demonstrate the Allscripts-MyCareTeam solution in clinical practice at the Allscripts booth (#3016). Presentation times are Tuesday, Feb. 21, at 3 p.m. Pacific Time and Wednesday, Feb. 22, at 10 a.m. Pacific Time.