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 These sobering statistics, coupled with the day-to-day struggle to deliver high-quality care with outdated care coordination tools, inspired a group of Harvard-trained physicians and engineers to join forces.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. […]

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 […]

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 […]

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 […]

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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 […]

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 […]

2016 is an important year for the healthcare industry, as clinicians look to Health IT organizations to deliver the innovation and insights they need to provide smarter care. Interoperability, precision medicine, actionable data – these aren’t just buzz words, these are the key drivers that will shape health care. Created for healthcare professionals, our magazine, Continuum, features industry insights and Allscripts client success stories. In the 1Q 2016 issue, you’ll find: Executive Insight: Taking the Lead – President and Chief Financial Officer Rick Poulton discusses how Allscripts Open architecture will help providers manage population health. Untethered: CIO Bill Phillips and University Health System – How one client combines Allscripts solutions to achieve better clinical results, earn millions and improve operational efficiency. Get Smart: Allscripts Analytics dives into big data to improve outcomes – General Manager of Allscripts Analytics Marty McKenna discusses […]