personal health record

What’s So New About CHR?

What’s So New About CHR?

The leading voices in healthcare are talking about the next big thing on the horizon. That would be CHR (Comprehensive Health Record). But what about the unfinished business that still exists for healthcare records? How do you incorporate the data from incoming external documents that bog down clinics and hospitals? This data comes from faxes, paper, and scanning workflows.

Media Tab Mayhem

Media Tab Mayhem

Do your clinicians have trouble finding relevant patient documents, whether it be on paper or in some digital library?  If so, they could be fighting with Media Mayhem or Media Tab Mayhem. 

Lab Result Orders and How to Get Them In The EMR With Automated Order Matching

Lab Result Orders and How to Get Them In The EMR With Automated Order Matching

In most healthcare institutions, medical procedures are associated with orders or encounters.  An order (or standing order) can be defined as rules, regulations, protocols, or procedures prepared by the professional staff of a hospital or clinic and used as guidelines in the preparation and carrying out of medical and surgical procedures. An encounter can be defined as a health care contact between the patient and the provider who is responsible for diagnosing and treating the patient. 

Population health without complete clinical data is like...

Population health without complete clinical data is like...

Your incomplete data set doesn’t tell you the full story.

A population health management program without the ability to analyze a complete set of clinical data is like reading a book with missing pages.  You’re left with only your imagination to fill in important details.

Specialty clinics still using paper? Get that data into your EMR!

What I know for Sure:

Discrete, trending data is the bread and butter of a specialty clinic.

Hunting and pecking through the media tab to track down information on a patient is infuriating! And not only for the doctors. For nurses. For abstractors. For the patient! Trending a post-transplant patient's drug levels alongside their medication doses, rejections, infections, transplant history, UNOS data, procedures, and relevant transplant-related scores is of paramount importance to a clinician and is very time sensitive. Getting all patient data into the EMR is the holy grail when it comes to specialty medicine.

Specialty clinics, especially transplant clinics, are mini-ACOs. 

When you are treating an acute, chronic disease it is critical that everything about the patient is known regardless of where they are being treated on a daily basis. Luckily, we now live in a world of Care Everywhere, CCD documents, and reference labs…BUT, despite what everyone wants to believe, these things are not a panacea.

Paper is very much alive and well in the healthcare world. 

Sometimes clinicians are "closet paper users," other times they just lay it out there. But don't make any mistake about it…they are using. In the transplant world, you may be familiar with the "wall chart." Also known as "the flowsheet" or "the flowchart." You know the one. The monstrous grid that is the holy grail for the transplant clinic, but is the disdain of the HIM team and the project team trying to migrate clinicians to the EMR. But there are good reasons for this chart and the other paper being used. Many hospitals have not implemented effective document management strategies that classify documents in useful ways. And many hospitals don't have the resources to support entering (and QAing) important data discretely as it comes in from external sources (or even internal sources such as the pathology lab).
 

Specialty clinics are crazy busy. 

There were times during my tenure at Epic that I felt stressed. That I felt my days were busy. That I felt it was hard to create work/life balance. And then I'd go onsite and spend a week in a transplant department. Wow. My workday was like a walk in the park! The chaos that is the life of a person in a specialty clinic is very hard to explain or quantify. It seems there is not a moment to breathe. And this isn't just for the doctors and nurses. Even the folks doing data entry are getting calls, being pulled into other things, being tapped on the shoulder constantly. It is nearly impossible to give something 100% of your attention.
 

Extract's products can help. 

I'm a passionate person. I don't back something I don't believe in and I don't work for companies whose product doesn't excite me. When I first encountered the Extract product I was very skeptical. Optical Character Recognition (OCR) with clinical data? Fuggettabout it! However, I've been able to peel back the curtain. The magic isn't in the OCR, it's in the rules, logic, and processing that Extract has fine-tuned while working with numerous healthcare organizations. I've seen it in action. I've seen the product improve with features that allow more reliable mapping to patients and existing orders. I've seen it process large documents and auto-classify subsections of that document and route them accordingly (think referral packets, transplant folks!). I've seen it work. I believe in the product and think it can improve data quality, care quality, data entry efficiency, EMR user happiness, and much more.
 

Extract's products aren't restricted to specialty clinics. 

Yes, it is very easy to see the benefit of using the product to discretely enter lab results or split/file referral packets in a specialty clinic. But once you've seen it in action, it's very hard not to let your imagination run wild. Have an HIM department that is backlogged and needs some help classifying and discretely filing data? Have a natural speech recognition engine that needs some intelligent processing and filing after the output is generated? Have Care Everywhere but wish that you could get some more discrete data from it, such as labs? Still have paper DNR, release forms, or patient surveys coming in and want them to be discrete?

Have any other ideas?

We want to hear them! You can email me directly to discuss your ideas further.


About the Author: Rob Fea

He has spent 12 years partnering with IT teams and clinicians at major hospitals and clinics worldwide during his tenure on the technical services team at Epic. For the vast majority of his time at Epic, Rob supported Epic's Phoenix product, playing a major role in project kickoffs, installation, data conversions, ongoing support, and optimization. During his tenure at Epic, he watched the Phoenix customer base expand from 0 to 55 live and installing transplant organizations. It was a terrific experience and he loved every minute of it. It gave him expansive insight into the healthcare world, especially the solid organ transplant industry. Rob has spent countless hours on the floor in transplant departments observing multidisciplinary visits, committee review meetings, data entry, data trending, reporting, medication dosing, and more.

Lab Data Requirements and Health Data Capture

Lab Data Requirements and Health Data Capture

The Centers for Medicare & Medicaid Services regulates laboratory testing performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA) to ensure quality laboratory testing. CLIA sets high standards for quality control, validation of data and tests, equipment calibration, proper training and certification of users and clear end result reporting that meets proper lab data requirements.

Part five of a seven part blog series about EMR - lab results interoperability.

Part five of a seven part blog series about EMR - lab results interoperability.

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.

Clinical data stuck in unstructured formats… It’s enough to raise your blood pressure.

Clinical data stuck in unstructured formats… It’s enough to raise your blood pressure.

As with every study, the article laid out the limitations of this particular study, which focused on blood pressure only, before getting into the detailed results of their work. The seven limitations they named were quite typical, including possible duplicate data and possible non-reporting of improved patients, but the limitation that seemed most unnecessary and raised my blood pressure indeed was, “Sixth, incentive program CQM reporting was based only on the data available in the EHR system of the health care provider. If a patient transitioned to another provider, such as a specialist, the original EHR might not have subsequent, possibly improved, blood pressure values recorded.”

Research and PHI – Oh, the many issues…

Research and PHI – Oh, the many issues…

In the course of a clinical research project or trial, researchers must gather patient data and records and prepare them for adjudication and analysis. In keeping with the spirit of HIPAA and PHI regulations, the organization conducting this research or trial likely wishes to control access from both within and outside of its firewall to ensure that any potential for breach of this personal information is strictly curtailed. 

“If I live to be 90 years old, I’ll never have enough interfaces for our labs."

“If I live to be 90 years old, I’ll never have enough interfaces for our labs."

Will you ever have all the interfaces you need?

“If I live to be 90 years old, I’ll never have enough interfaces for our labs,” the lab director of a large healthcare organization recently commented. “And with the costs and ongoing maintenance, how can we afford them?”

Transplant Outreach Part 4: Educate, Build, Enhance Relationships with the Referral Community

Transplant Outreach Part 4: Educate, Build, Enhance Relationships with the Referral Community

In our first three blogs of this series, we discussed how educational outreach can lead to opportunities to facilitate more effective patient care locally and strengthen relationships with referring providers. We have focused on the structure of these efforts; now we will focus on the provision of these services and how to differentiate your efforts from others to ensure your investment pays dividends.

Part one of a seven part blog series about EMR - lab results interoperability.

Part one of a seven part blog series about EMR - lab results interoperability.

There are several misconceptions about interfaces and intelligent clinical data extraction software and lab results interoperability in general that I’ll attempt to clear up in a series of seven blog posts.

Justify Before you Buy: Automated Capture for Clinical Data - Part 3

Justify Before you Buy: Automated Capture for Clinical Data - Part 3

You finally found the perfect solution to problem of getting data out of documents and into your EMR or other system. It’s a system that automates this data entry and the workflows surrounding the entire document handling and quality assurance processes. Now it’s time to go ask for permission (budget) to purchase this solution.

Outreach Workshop Part 1: The Big Picture

Outreach Workshop Part 1: The Big Picture

In our next series of blogs, we will discuss the concept of outreach and how programs can use it to improve not only their volumes, but also their outcomes. Outreach can be simplistically defined as the act of reaching out to a group.  It may also be defined as a systematic attempt to provide services beyond conventional limits to a particular segment of the community. In this blog, we will concentrate on the former definition, namely, reaching out to different groups to grow our program.

Data Security and the Personal Health Record (PHR)

Data Security and the Personal Health Record (PHR)

Cleveland Clinic is opening up the patient file, as in the entire patient file, to their patients. I’d like to have been a fly on the wall listening to the arguments in favor and against. Current wisdom seems to be “more information is better”. But I wonder.