The year is now 2017 and we have been a digital society for quite some time, but if you talk with people in the healthcare industry, you will find that paper is still floating around. In 2016, we worked with two major hospitals and you would be amazed by not only how prevalent paper documents are, but how these paper medical documents get copied and moved to different people through the hospital, this is what we call the “Paper Shuffle”.
Non-interfaced data in healthcare is the “bane” of all clinical and administrative staff. If data is not interfaced, it’s not in the fields of the EMR, not in flow sheets, reports, trend analysis, etc. It causes more work for it to be moved, stored, and made accessible in EMR as scanned documents or otherwise. It makes continuation of care and quality of care much, much harder.
One of the major attractions of having an EMR system is the ability to track and trend patient data. Ideally, with a click of the mouse a clinician should be able to instantly see trending lab results to influence their diagnosis. According to a studyby Mayo Clinic, 60-70 of clinical diagnoses and treatments are based off of lab results. In fact, the importance of having complete and accurate lab results in the EMR was included in step one of the Meaningful Use guidelines, as stated on HealthIT.gov.
In the medical field, if you are an organization that receives incoming faxes of documents, you could have dozens of different categories. However, if you are part of the organization that manages lab results, the most important documents are those lab results, then everything else. In a world consumed by managing documents, proper classification and routing is critical to controlling these lab results. CAP Today outlined the need for lab documents control in their article, Bedeviled by Documents, Labs Seek Control.
There’s no question that users rely on the EMR In Basket for day-to-day workflow management. The “In Basket” or “Inbox,” depending on what EMR you’re using, provides a centralized location to receive notifications and important patient information, such as admission and discharge notifications, new lab results, refill requests, patient calls, appointment reminders, patient portal communication and much more.
Critical results reporting or reporting lab results for priority patients from non-interfaced sources is no easy task. A delay in reporting can yield an unfortunate outcome for a patient whose condition is deteriorating. This is especially true for specialty departments that provide continued care for patients from far-flung locales, such as the transplant program. One transplant department receives thousands of these reports over a single patient's lifetime, and often hundreds of these documents for its patient population each day by fax.
Health data challenges are a part of any healthcare organization. Frustration is a natural consequence. This is also a common topic in most healthcare press lately. It often feels like depending on which way the wind is blowing, the consensus is that EMR adoption by clinicians is either improving or getting worse. A recent KLAS report indicates adoption is improving across the globe. The decision to move to an enterprise EMR for most organizations often includes as a factor the goal of reducing the total number of applications supported. Initiatives to improve adoption then becomes a challenge if your department's prized application is removed for something "less than robust". Along with pain and frustration, keeping your clinicians happy is also a challenge
Tracking data in your transplant care software is a key component of QAPI programs, not only for CMS, but now also with UNOS debating the requirement of QAPI programs. One of the most challenging aspects of transplant program management is ensuring that your Quality Assessment and Process Improvement programs are measuring meaningful and actionable items that lead to program improvement.
In my previous post, the fourth in a series of seven blog posts that discuss some of the misconceptions about lab interfaces and intelligent clinical data extraction software, I addressed the belief that if a hospital has an in-house laboratory, all test results will be integrated with the patient record in the EMR.
As I’m standing in line at my favorite coffee shop, I’m thinking about how baristas have perfected workflow; and now have improved perfection by allowing me to eliminate the line entirely by ordering in advance with my smart phone. It always excites me when I see a sequence of steps refined for optimum efficiency. I know it's odd, but I'm really strange like that.
When asked to evaluate workflow processes in transplant programs, we often here from hospital administrators that their transplant program is over-resourced and they do not understand why work-up time is so long, why patients complain that it takes so long to get a phone call returned or why the physicians always ask for more staff. " Do you know what your transplant staff is truly doing?", is usually the next question we ask. Not to our surprise, the answer is "of course".
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.