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Incorporating Continuation of Care Documents into your EHR

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Incorporating Continuation of Care Documents into your EHR

When you hear people talk about a Continuity of Care Document (CCD), funny enough, it’s actually usually a “document”. In reality, the specification for a CCD, according to Wikipedia, is “an XML-based markup standard intended to specify the encoding, structure, and semantics of a patient summary clinical document for exchange.” CCDs are important to patient’s treatment, but its original intention of being a way for pertinent patient information to be transferred one system to another has not yet been realized. So, when patients are referred to another physician or if CCDs are trying to be used to convert massive amounts of data from one EHR to a new EHR, the exchange of information is often not seamless.

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Does your new EHR mean more data entry?

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Does your new EHR mean more data entry?

Transplant care teams have enough challenges managing patient information arriving from outside their institution. It's already a full workload entering primary data from the transplant evaluation process. It's a never ending process of data entry for solid organ programs. EHR adoption is adding to that already heavy workload and is creating the need to enter more discrete data. Ask yourself: isn't it enough that your solid organ transplant teams sift through a large number of non-electronic patient details from their originating healthcare institution?

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Automated and Standardized Data Entry

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Automated and Standardized Data Entry

If you had electronic tools to automate data entry, capture the valuable data that is currently coming to you in electronic and paper documents, and use it immediately to make essential clinical decisions, would you ever go back to the entering data the old way?  

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PHI in Medical Research

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PHI in Medical Research

There’s been a lot of news lately about the 2015 NIH budget being flat, worrying researchers that the funding pinch will have a significant impact on current and future projects. Even Nobel prize winning researcher Craig Mello from the University of Massachusetts Medical School recently commented on the impact this could have on his ongoing work, noting that if he couldn’t get a grant he’s applied for he may have to reduce staff.

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Transplant Program Staffing

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Transplant Program Staffing

As we assist various programs around the country, one of the things we are asked is how does a program balance staffing constraints while accomplishing the many administrative and clerical tasks that are required and still deliver high quality patient care. Frequently when addressing staffing situations, what we find is that programs may have sufficient staff but everyone is doing so many other tasks that it detracts from their true function. Other times, we find that the program is simply understaffed for the volume or number of patients that they are caring for. While the scenarios seem to be different and one would think require different solutions, an assessment of staffing needs begins with an understanding of each role and what tasks that role is actually required to do (not just what we think they are doing). Once the tasks are defined, an understanding of the work flow processes and the current operational chains that each task requires is needed.

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Clinical Labs: Meeting the needs of providers is a juggling act

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Clinical Labs: Meeting the needs of providers is a juggling act

The ultimate juggling act: clinical labs in a hospital setting are required to maintain the highest operational standards. They complete their own inpatient testing while managing the logistics of send-outs and the returning results from reference and specialty labs. No matter where it’s coming from, comprehensive data needs to get back to the ordering physician -  data required to make the best care decisions.

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18 Years Later… Data Accuracy and Integrity in Healthcare

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18 Years Later… Data Accuracy and Integrity in Healthcare

I was researching topics around data accuracy in healthcare the other day and came across this AHIMA article from 1997 (did we even have the internet back then? J). The article was focused on a growing demand for accurate coded data and as I read the article, I felt that AHIMA was ahead of its time and like I was in a time warp. They were stating the importance of data accuracy and consistent coding to speak about how “these data are used to assess resource utilization and outcomes throughout [accurate-data] the delivery system and to develop plans for the provision of more efficient and effective patient care.” 

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Interoperability, yes, but with truly accurate data

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Interoperability, yes, but with truly accurate data

Interoperability, yes, but with truly accurate data

A mid-Atlantic hospital’s transplant program recently went live with Epic Phoenix to better track pre and post-transplant patients. Prior to the Epic implementation, all patient data was maintained manually on paper flowsheets.

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Data Management for Post-Transplant Follow Up

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Data Management for Post-Transplant Follow Up

One of the many advances that have been achieved in transplantation care today is the ability of patients to return to their community physicians after a period of time for most of their long term care.

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A Cure for the Interoperability Blues?

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A Cure for the Interoperability Blues?

Let’s imagine that you like the features of your transplant database and your hospital is transitioning your department away from your comfortable and dependable software, into an enterprise application. You’ve likely heard this transition makes sense and will provide costs savings for the entire organization, but you might be wondering if the cost savings will benefit your department. There are obvious economies of scale with an enterprise solution, but you can’t help but wonder if this will create new problems for you. Having access to clinical data within the continuum of care is wonderful, but it hasn’t eliminated the need for a fax machine.

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Waitlist Management and Improving Transplant Center Outcomes

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Waitlist Management and Improving Transplant Center Outcomes

One of the universal issues we face when asked to help a program that has below standard outcomes, is how that program handles workflow and data management challenges. A big part of managing a transplant program is collecting and managing all the information needed to make good decisions. For instance, regardless of the type of transplant, one common factor that determines who receives the Gift of Life, and when, is the Waitlist. Management of this seemingly simple list can become a daunting task[waitinglist] when one considers the complexities of not only transplantation itself, but also of the information management required to determine appropriate candidates to place on the waitlist and ultimately carry out that transplant.

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Computer-Aided Abstraction Assists with CTR shortage

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Computer-Aided Abstraction Assists with CTR shortage

As I wrote recently, the Certified Tumor Registrar shortage is currently being exacerbated by the Commission on Cancer’s CTR Standard 5.1. I’m not saying the standard is not a worthy step to ensure that the abstraction of patient records to local registries and the NCDB is accurate - just that it clips the available pool of in-house or outsourced personnel to keep up with the load.

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Can advanced data capture solve your employee turnover problem?

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Can advanced data capture solve your employee turnover problem?

You've just installed a new electronic health record and a dedicated module for transplant.

Now you discover your long term medical secretary, who is capable of typing 90 wpm, is planning to retire. What do you do? High turnover in any service line is a problem, but when you have a constant flow of paper in an environment that requires up-to-the-moment patient data, it is only a matter of time until patient safety becomes your primary sense of urgency. What are your options? 

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Keeping up with Transplant Patient Re-verification

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Keeping up with Transplant Patient Re-verification

A pressing issue in transplantation today is appropriate organ allocation and ensuring that the sickest patients and those who would benefit the most are afforded the gift of life. In order to be listed, all patients require certain specific data points in order to be successfully entered into the national database and deemed active on the waitlist. For some patients, such as those awaiting a lung or liver transplant, organ allocation is driven by scoring systems (the LAS and MELD score respectively) that are a reflection of disease severity.

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Can advanced data capture help with Data Conversions?

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Can advanced data capture help with Data Conversions?

Every patient has a history. Getting those histories moved from other systems and sources is an important consideration when implementing a new EHR. Whether your healthcare organization is deploying a new EHR, replacing one or implementing a new module in an existing EHR, your ability to capture data into the fields of the new EHR/module will define how fast you can use that history to make better care decisions.