Bio: Tina Joros is the Vice President and General Manager of the Open Business Unit. Tina is responsible for managing the day-to-day operations of the Allscripts Developer Program (ADP), ensuring information, documentation and support is available for developers through online tools, such as the Allscripts Developer Portal (http://developer.allscripts.com), and marketing the applications, integrations built by developers directly to our client base through the Allscripts Application Store (https://store.allscripts.com). Prior to her role in developer relations, Tina served as Associate General Counsel for Allscripts (Eclipsys Systems), with responsibilities for third-party contracting and partner management, client contracts, privacy and security issues, and labor and employment matters.
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- Guides front-desk staff through triage intake when patients first call
- Helps route calls appropriately with full documentation, so patients don’t repeat themselves
- Enables custom protocols and custom routing
- Supports consistent workflow and patient service
- Streamlines after-hours handling and documentation, removing the daily faxes
- Includes clinical decision support
- Reduces liability by automating triage documentation and sending data to the EHR
Sometimes the best way to capture information is with a picture. Photographs can help clinicians diagnose conditions and monitor progress, especially in specialties such as plastic surgery, dermatology, burn care, wound care and vein care.
Clinical photography can be helpful in these cases. However, due to the technical skill needed to capture accurate, repeatable photographs, these pictures rarely provide comparable, measurable (read “quality”) data for providers. While clinical photography systems that have mechanical positioning, lighting and software are a valuable means of standardizing images, they can be costly and lack the mobility, simplicity and connectivity of mobile devices.
Epitomyze, Inc., part of Allscripts Developer Program, seeks to bridge this technology gap between legacy clinical photography systems and modern telemedicine. Set to revolutionize the role of clinical photography in medicine, the epitomyze™ capture app enables mobile devices to easily and inexpensively capture and accurately reproduce clinical photographs over time. Captured images provide “apples to apples” comparisons of clinical results and reside in Epitomyze’s secure, HIPAA-compliant cloud, ImageStore®. Clinicians can store, tag, search and share them with other providers, patients or payers.
An academic health center burn unit uses the application, and a clinician shared the following feedback:
“The photo application is simple to use and providers can easily obtain wound photos. The photos are then immediately available in ImageStore so that the provider can see comparisons of the wound over time. These comparisons are used in conversations with the patients to show them the progress of their wound and engage them in their plan of care…All of the providers on our team have access to the photos and can easily collaborate in person or via electronic means to discuss the care of the patient.”
By filling this gap, clinicians can more easily obtain vital information, provide better information for analysis and share with other components of the healthcare system. Learn more about epitomyze™ on the Allscripts Application Store or join us for an upcoming webinar.
Patient portals are essential communication tools for many providers and patients today. For example, more than 9.3 million patients have accounts through the Allscripts FollowMyHealth® patient engagement platform.
But a recent Nielsen survey found that the majority of Americans are not using digital technology to access their physicians – which is unlike how we approach other aspects of our lives, such as banking or making travel arrangements.
Application Programming Interfaces (APIs) can help address this challenge. Because for the first time ever in the United States, Meaningful Use attestation requires providers to use APIs to better engage patients in their care and enable them to have more control over their health data. APIs are those essential toolkits that enable different technologies to exchange data. They’ve hidden in the background of the industry’s patient engagement efforts until now.
Through its Meaningful Use Stage 3 (MU3) program, the Centers for Medicare and Medicaid (CMS) requires healthcare providers to have at least one application that enables patients to access their health information via an API from the organization’s electronic health record (EHR).
Specifically, the MU3 requirements regarding APIs cover four main areas:
Make it easy for patients (or their representative) to request, use and organize health information. Display data in a way that is accessible regardless of age, technical ability and/or disability.
Patients should be able to request data, and the organization should be able to respond to the patient, using an open API.
Data category request
Patient requests for data must be in compliance with new data category standards from the ONC, and must be available for a specific date and specified date range.
All data request
Patient requests for data must be completed in the CCD template format, and patient requests for data completed in the C-CDA format for both a specific date and specified date range.*
CMS also requires that patients should be able to use any application that meets EHR specifications to access their health information. This opens the door to more third-party software developers who have not had the opportunity to participate in closed systems.
What will this mean for patients? We can expect more options in direct-to-consumer applications, especially Personal Health Record (PHR) apps. Apple’s App Store currently lists more than 65 PHR apps from third-party developers, and that number is sure to rise in the wake of these requirements. Patients will be able to use portals offered by providers, or select the PHR that works best for them.
It’s business as usual for Allscripts
These requirements might cause some EHR vendors to rethink their approach to third-party, patient-facing applications. But Allscripts has been building and supporting open APIs for nearly a decade. This new requirement is business as usual for us and I’m glad the government is making this requirement.
When Allscripts clients upgrade to MU3 versions of Allscripts Sunrise™, Allscripts TouchWorks® EHR and Allscripts Professional EHR™, they automatically get our open API technology, which includes FHIR-enabled endpoints. No additional contract or license, no separate installation or update is required.
Earlier this year, Allscripts launched a Developer Challenge to increase the number of patient-facing applications using Allscripts open APIs that meet the MU3 requirements. We had 22 companies submit applications for the challenge, and named first place winner Medlio and runner-up PatientLink Enterprises for their innovative solutions.
Successful patient engagement is about offering choice. Through our FollowMyHealth platform and the Allscripts Developer Program, we continue to work toward improving health care collaboratively. Whether it’s addressing MU3 requirements for patient-facing applications, or the next regulation that shapes health care, our solutions help position our clients and partners for success. To learn more, visit our Application Store to see the solutions we have available today or sign up to become a developer.
* CCD (Continuity of Care Document) and C-CDA (Consolidated-Clinical Document Architecture) are common, structured electronic data formats developed by Health Level Seven International (HL7), a nonprofit standards organization.
Working with health information technology companies every day can be exciting – you get a chance to see futuristic solutions that you know will have an impact on generations of people receiving health care.
But the origin of these solutions can be quite heartbreaking. You hear stories of medical errors and information gridlock that led to devastating results for loved ones.
Here is a story that Patrick Randolph, CEO of QueueDr, told me about his friend, who had to wait three weeks to find out he had multiple sclerosis (MS):
Recently, my oldest friend in the world, who I’ve known for 27 years, found out he had MS. Not a death sentence, but definitely worse than your average Tuesday.
My friend told me how lucky he was that they caught it early. His doctor repeatedly stressed to him how even an extra day of treatment for MS makes a world of difference. Then, my friend told me that he had had to wait three weeks for his appointment to get diagnosed.
I’ve never been prouder that we created QueueDr and work with some of the top practices in the country who make sure their patients get the care they need when they need it.
QueueDr automatically fills cancelled appointments by texting patients, like my friend, who have appointments that are far out in the future. My friend could’ve gotten his diagnosis and begun treatment three weeks earlier.
But QueueDr offers a huge benefit to the practice and their staff as well. The practice would’ve been able to fill last-minute cancellations and prevent no-shows that plague the schedule. Even better, the staff never have to do a thing because QueueDr is 100% automated. When a patient replies to claim the appointment, QueueDr moves it up in the practice’s schedule. No buttons, no lifting a finger.
We are proud of QueueDr, which is why it has been our App of the Month multiple times over the last few years. If you want to see this award-winning integration into Allscripts Practice Management™ and Allscripts TouchWorks® EHR, register for their webinar on August 30 at 1 p.m. Eastern time. Your patients will thank you.
To provide the best quality care, clinicians need detailed information about a patient’s medical history and status. They need to know existing information is correct, and also about new details in patients’ lives that could affect their care.
Some days, I’m organized and build in time to prepare for upcoming appointments. I may be able to go to an online site and complete the updates and information necessary for my visit in advance. During busy days and weeks, it might be all I can do to get to the appointment on time, and having an onsite option like a kiosk in the waiting room to update my medical history becomes vital to making sure my doctor has all the best data about me.
As a person and a patient, I like options. I want to engage with practices who use tools that provide different methods of data collection. Our App of the Month for July, PatientLink, enables physician practices to offer several methods to capture patient information and upload it as discrete, structured data into Allscripts Professional EHR™.
“Our goal is to help free clinicians to take care of patients by automating the tedious data entry into the EHR,” said Debi Willis, CEO and Founder of PatientLink. “With the option to complete forms online before the appointment, in the waiting room through a kiosk, or on paper, patients are empowered to choose the option that best fits their lifestyle.”
PatientLink’s template forms enable clinicians to capture past medical history, surgical history, social history, family history, review of systems, medication, allergies, meaningful use, scored assessments, Medicare Wellness forms, Physician Quality Reporting System (PQRS) measures, Accountable Care Organization (ACO) measures and research data. PatientLink works closely with clinics to fully understand their needs and to customize and create forms based upon those needs.
“With the move from fee-for-service to pay-for-performance, payments are now linked to outcomes, and outcomes are measured by data,” Willis said. “PatientLink’s ability to quickly capture and send structured data into Professional EHR frees physicians to focus on patient care, which is the ultimate goal of every provider.”
Physician offices give PatientLink positive reviews
PatientLink helps improve workflow, generate revenue, gather data for quality measures, and increase the quality and completeness of data for medical offices. Here are just a few examples of how PatientLink has helped physician offices:
“The history is far more extensive, meets meaningful use requirements, and — most importantly — saves 15 to 20 minutes rooming every new patient.” – Lyn Clements, Clinic Administrator, INTEGRIS Family Care Yukon
“If I had an employee who could do 150 histories a day and never took a day off or called in sick, I would pay her a lot more than I paid for this scanner.” – Dr. Steve Hess, Westgate Family Physicians
“PatientLink probably cut the time it previously took nurses to review patient history and review of systems by about two-thirds.” – Dr. Richard Hellman, Hellman & Rosen Endocrine Associates
Patient engagement is of the utmost importance, and PatientLink provides more time for meaningful interaction between clinicians and their patients.
Register here to join the Allscripts “App of the Month Webinar” on Thursday, July 28 at 1 p.m. Eastern time to learn how PatientLink can help providers give options to patients that help improve patient care, and save time and money.
When there’s a customer support issue – with our cell phones, cars, banking or online shopping – the answers are not always on a website or app. Sometimes we want or need to call. The experience can quickly get exasperating if we’re transferred multiple times, repeating account information, security questions or other information. Based on previous experiences, there are companies I don’t mind calling for an issue, and those I never want to speak to again.
Healthcare providers want to create an environment where patients have a great experience. It doesn’t matter if they are a new patient calling to get information on the practice, or an established patient calling to schedule an appointment, ask a question about a health-related issue or follow up on results. Whatever the reason for the call, providers want their patients to avoid the pitfalls of frustrating phone calls.
No matter what company or organization I call, I expect (and appreciate) these experiences:
Single contact resolution: Phone agents have access to a knowledge base with easy instructions that enables them to address more issues. Or, they’ll collect the right information and convey it to a technician that can solve the problem. This saves the customer from repeating the entire story, and saves the technician’s time.
Continuity: All interactions are recorded and accessible. So the phone agent can understand what the customer has already told the store agent, saving time for everyone.
Healthcare practices can improve the call experience
Many healthcare issues need to be handled by a trained expert, either a nurse or a doctor. Practices can achieve single contact resolution and continuity, helping ensure patients have a great experience, whether they are calling on the phone or are there in person.
Cindy Feeley, director of patient relations and process improvement at Chesapeake Urology (Owings Mills, Maryland, U.S.A.), has experience implementing next-generation telephone triage. As a former executive over call centers for banks like Chevy Chase and Citibank, Cindy brings customer service expertise from finance to healthcare telephone triage.
Cindy empowers her phone staff for speed and accuracy using , a telephone triage and expert system. It’s the only software of its kind integrated into Allscripts Professional™ EHR and Allscripts TouchWorks® EHR platforms.
Health Desk is an Allscripts-certified solution that:
You can provide better telephone triage for your patients. Register for a webinar on June 29 at 1 p.m. Eastern time to hear Cindy’s story. Learn more about this innovative solution on the Allscripts Application Store.
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.
How the Yosko app works
The Yosko app builds comprehensive information bridges with Allscripts Sunrise™ to enable every app feature to be anchored in the real-time clinical context of an electronic health record (EHR). This integration helps hospital teams engage in completely paperless patient rounds through an intuitive user interface that maps to the provider’s workflow.
For clinicians, this means they have a communication and notification platform that ensures that every team member is up-to-speed on the patient’s clinical status and planned hospital course. This capability helps improve safe transitions of care, expedite discharges and prevent delays in acting on critical testing results.
The Yosko app supports visual diagnosis and remote consultation through photo capturing of rashes, wound changes, even EKGs and other results. Because the app is integrated with clinical decision support tools, it helps providers treat patients according to latest clinical guidelines and practices.
Yosko Chief Executive Officer Andriana Nikolova, M.D., said: “Allscripts is a truly visionary company by pioneering the Open API platform. It recognizes that we can deliver even better patient care when we combine the rich possibilities of an EHR like Allscripts Sunrise with new mobile care coordination tools that enhance the EHR offering. We are seeing enthusiastic reactions to this partnership from clinicians at our pilot sites that include some of the leading U.S. hospitals.”
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 than four months, and an envelope stuffed with hundreds of results left on someone’s desk at another site.
“We saw direct evidence of the pain points when clinicians manually enter test results,” Farish said. “So we built Relaymed to fully automate this workflow and optimize performance – no clicks, no typing, no hassle.”
Every time Relaymed sends data to be stored in Allscripts Professional EHR™ or Allscripts TouchWorks® EHR, it saves staff the time it takes to enter a patient lab test. Relaymed has already helped Allscripts clients save nearly 200,000 lab results in real time. With it taking an average of two minutes per test entry, Relaymed estimates the cost saving at more than $60,000.
Best of all, because the test result is available instantly in the EHR, the ordering provider has the right information, in the right place, at the right time. Clinicians can either discuss the results with patients or make a clinical decisions based on seeing the results in context with the rest of the patients’ medical information.
Ready to learn more? Register here to join a Relaymed webinar on Tuesday, March 29.
With today’s technology options, it surprises me how many physician practices still hand clipboards to their patients at registration. New applications can not only get rid of paperwork, they can help practices collect better data and more payments during the check-in process.
Phreesia, one of our certified partners in the Allscripts Developer Program, helps practices increase collections, verify eligibility, reduce paperwork and increase patient engagement – all at the point of service. Phreesia supports integrations with Allscripts Professional EHR™, Allscripts TouchWorks® EHR and Allscripts Practice Management™ (and coming soon with Allscripts Payerpath™).
Here are eight benefits of digitizing the patient intake process, according to Phreesia and Allscripts client Barry Oursler, Director of Clinical and Business Systems at Chesapeake Urology, the largest urology practice in the Mid-Atlantic (U.S.A.):
- High satisfaction rates, even among older patients. According to Oursler, the notion that older patients struggle to use the PhreesiaPad is false. “In fact, it’s actually the opposite,” he said. “The pad is easy to use. For patients who are arthritic and have trouble holding a pen, the pad solves that problem, and the answers are legible.”
- Improved patient experience. The redundant questioning that comes with clipboard check-in is a real source of frustration for patients. “Phreesia treats each patient uniquely, only positioning the pertinent questions for that patient’s unique profile, and reduces that data entry burden,” Oursler said. “We built customized interviews for new patients and for patients returning within 30 days, one to five months, five months to a year, and over a year. We were able to think about how frequently we needed to ask each question.”
- Standardize compliance form updates. Like all practices, Chesapeake Urology has a list of forms that must be updated on a regular basis. For instance, healthcare providers in Maryland are required to update patients’ HIPAA forms annually—a herculean task for a 30-location practice. “Now, Phreesia does it for us,” Oursler said. “The software knows the right patient, the right visit and the right time to ask for an update.”
- Show patients what they owe without uncomfortable conversations. Because Phreesia automatically asks patients to pay co-pays and outstanding balances, it boosts collections while freeing staff from the need to have awkward financial discussions. “Our people are in health care because they care about folks,” Oursler said. “They don’t want to be involved in financial conversations, and Phreesia minimizes that need.”
- Simplify pre-collections and refunds. “Surgical practices and patients are burdened with the ability to only estimate a patient’s financial responsibility before a surgery.,” Oursler said. “Phreesia helps us verify eligibility and estimate what procedures will cost. Because insurance deductible information is constantly changing and some patients need budget-friendly options, we use Phreesia’s flexible credit card payment plan system and the card-on-file option to eliminate the practice and patient burdens associated with post-service collections.”
- Modify interview questions on the fly. “Because it’s all Internet-based, Phreesia enables us to add or change interview questions – even in the middle of a patient session,” Oursler said. “For example, after the first Ebola case broke in the U.S., we were able to add two screening questions for Ebola the very next day. Adapting to current challenges is very difficult on paper.”
- Eliminate duplicate data entry. According to Oursler, Phreesia’s integration with Professional EHR has enabled Chesapeake Urology to reduce inefficiency and streamline its workflow. “We have about 15 to 18 data elements that automatically integrate with Professional EHR, which means our staff doesn’t have to enter them separately,” he said.
- Improve clinical survey data. “One of the common clinical surveys in urology is the International Prostate Symptom Score (IPSS) to evaluate risk for prostate cancer,” Oursler said. “Phreesia can automate this process, only positioning the survey to the gender, age range, and frequency of visit requirements the physician may have for wanting that assessment. The accuracy and consistency of this information drives quality patient engagement.”
To learn more about Allscripts January App of the Month, Phreesia, and how you can better manage patient intake, view a free webinar recording here.
Studies show that some physicians are spending more than 40% of their time on patient notes, leading many providers to feel like they’re spending less time with patients and more time with patient documentation.
Several alternatives try and address this issue, from creating templates that enable a clinician to easily document common problems, to hiring scribes to handle data entry while the physician is examining the patient. Each method has its advantages and offers some benefits, but Allscripts Developer Program partner NoteSwift offers an alternative solution that uses voice direction to help providers move quickly through the patient chart and document or place orders with speed and accuracy.
Developed by a neurologist who felt the pain and tedium of patient documentation in his own practice, NoteSwift enhances productivity for providers in every specialty so they can see more patients and get home earlier.
When you speak with NoteSwift, the electronic health record (EHR) listens
Tightly integrated with Allscripts Professional EHR™ and Allscripts TouchWorks® EHR, NoteSwift improves documentation processes with speech recognition. For example, the clinician can move easily through the patient chart using voice commands and document a problem to support billing codes. When entering a prescription, the clinician just says the drug name, strength, quantity and refills. In less than five seconds and without a single click, the e-prescription is complete.
To learn more about NoteSwift’s workflow, watch this one-minute video:
To learn more about NoteSwift, register for these upcoming webinars:
- NoteSwift for TouchWorks EHR: Tuesday, November 17 at noon Eastern time Register
- NoteSwift for Professional EHR: Thursday, November 19 at noon Eastern time Register
Sometimes a little preparation can save a lot of time and frustration, especially before a visit to the doctor. It can improve patient experience and help physician practices protect their bottom line.
According to AMA Wire, “Pre-visit planning can increase efficiency often saving 30 minutes of both physician and staff time per day. In a practice with 220 clinic days a year where a physician’s time costs about $3 a minute and staff time costs about $1 a minute — that’s about $26,400 a year.”
CHADIS is a web-based questionnaire delivery, decision support and patient engagement system. Pre-visit data collection enables the clinician to focus on patient concerns and visit agenda.
How does CHADIS work?
Patients, parents or teens respond to the questionnaires online (from home or waiting room using a tablet or phone) prior to the office visit, helping ensure a complete assessment. The online screening saves office staff time – no more paper, manual scoring and scanning of the questionnaires, like the ASQ-3™, M-CHAT-R™, Vanderbilt Assessment Scales and others. CHADIS is now being used in 48 states across the U.S. and seven other countries, and facilitates a completed questionnaire every 30 seconds.
“Using CHADIS as an integrated solution with Allscripts TouchWorks® EHR has provided us the capability to more consistently and effectively reach our patients with questionnaires prior to arriving for their well child visits,” said Christopher Duskin, Senior Application Specialist, Hutchinson Clinic. “Additionally, the direct insertion of completed questionnaires to the electronic medical record allows our clinical staff to focus on the scores and responses, instead of worrying about how to access the information.”
In addition to quality improvement, CHADIS can help practices increase income with health, developmental and emotional screening tools eligible for 96110, 96127 and 99420 billing codes to insurance or Medicaid. In addition, CHADIS uses patient-generated documentation to verify visit complexity for higher-level codes.
CHADIS’s newest innovation
CHADIS has recently developed an innovative capacity to match patient-generated data with guided clinician decision-making. A “patient-specific template (PST)” provides decision support and “moment of care” supports clinical training. With this approach to clinical training and facilitation of guidelines, CHADIS earned recognition as the only mechanism provided by an IT company that is certified by the American Board of Pediatrics (ABP) to create and administer required “quality improvement” “Maintenance of Certification (MOC-4)” programs for credit.
Register here to join the Allscripts “App of the Month Webinar” Tuesday, October 27 at noon Eastern time to learn how CHADIS can help practices using Allscripts electronic health records (EHRs).
To learn more about CHADIS and Allscripts, visit the Allscripts Application Store.