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Articles on this Page
- 02/22/18--12:08: _Selecting the Right...
- 02/23/18--06:49: _Epic to demo new So...
- 02/23/18--08:39: _Meditech touts clou...
- 02/23/18--09:31: _Patient advocate: H...
- 02/24/18--11:21: _Optimizing your EHR...
- 02/26/18--07:28: _Geisinger spinoff x...
- 02/26/18--12:31: _InterSystems teams ...
- 02/26/18--13:52: _Change unveils clou...
- 02/27/18--05:57: _Just 4 years after ...
- 02/27/18--06:11: _ Dell EMC focuses o...
- 02/28/18--08:49: _eClinicalWorks to l...
- 02/28/18--11:23: _Bipartisan Senate b...
- 02/28/18--12:49: _Carequality's inter...
- 02/28/18--13:17: _Telmediq adds call ...
- 03/01/18--07:12: _EHRs steal primary ...
- 03/01/18--09:21: _Missouri Health tap...
- 03/01/18--10:52: _Cerner to showcase ...
- 03/02/18--07:09: _Health Catalyst unv...
- 03/02/18--08:15: _DoD-Cerner EHR proj...
- 03/02/18--09:00: _Smarter care: Focus...
- 02/22/18--12:08: Selecting the Right EHR for Your Practice
- 02/23/18--06:49: Epic to demo new Sonnet EHR at HIMSS18
- 02/24/18--11:21: Optimizing your EHR investments ― The next leap forward
- 02/28/18--13:17: Telmediq adds call center console to its communication platform
- 03/01/18--07:12: EHRs steal primary care doctors face time with patients, study finds
- 03/01/18--09:21: Missouri Health taps Cerner to streamline revenue cycle
- 03/02/18--08:15: DoD-Cerner EHR project finding improvements, despite some challenges
The purchase and implementation of an electronic health record system is no small feat—especially for small practices, who frequently have limited resources, staff and capital to invest. This handy guide is designed to help those small practices.
Last year at HIMSS17 Epic Systems founder and CEO Judy Faulkner announced the company was developing two new EHRs for hospitals that don’t need the full version of Epic.
This year at HIMSS18 attendees can get the first look at Epic Sonnet, which Faulkner described as Epic technology with some of the features removed, and at a lower cost.
She explained that smaller hospitals might not require the full version of the Epic EHR, yet they could add all the Epic features later.
Epic will also share more at the booth about the One Virtual System Worldwide, which the EHR maker revealed at the end of January. It’s an initiative designed to help Epic users not only exchange more images and data, but also interact with each other more.
“Epic has been moving beyond the walls of traditional healthcare for several years now,” said Sean Bina, Epic Vice President of Access Applications.
Bina cited Epic’s work reducing drug costs for patients by connecting to retail pharmacies and PBMs and collecting and sharing social determinants of health across the Epic community as examples.
Bina also said that Epic has expanded its MyChart portal. Patients can make payments, set up payment plans, and generate detailed estimates based on their benefits. More and more, patients use MyChart as a hub to pull together their health and wellness data with their goals, results, and care plans, Bina said.
“We are seeing an explosion in patient engagement and consumerism – not only in terms of the number of patients using MyChart, but also in terms of the depth of their use,” Bina added.
Epic will be at Booth 4432.
An inside look at the innovation, education, technology, networking and key events at the HIMSS18 global conference in Las Vegas.
Meditech had a big year in 2017. Nearly 100 clients adopted its new web-based EHR, with almost four dozen of them representing new customers. Now the longtime electronic health record leader (founded back in 1969, the company has a decade on competitors Epic and Cerner) plans to continue that momentum in 2018 and beyond, said Helen Waters, Meditech's executive vice president.
"For Meditech, the pivot is real: In 2017, we signed 92 healthcare organizations with 47 of the healthcare organizations representing new customers to the company," she said. "We are the only EHR vendor to offer a full-scale EHR designed specifically for the post-meaningful use era, and we are excited to showcase our latest innovations."
The Web EHR helps support team-based care and enable easier care coordination, company officials say. It allows for better physician-patient interaction and less "screen time." At the same time, it can helps accelerate care delivery and reduce physician burnout, according to Meditech. Portability across and devices, allowing it to be accessed in any care setting, is gravy.
The "next digital transformation of healthcare is underway," said Waters, and the company's Web Enterprise Health Record is expressly aimed at offering customers a cost-effective tool with more sophisticated clinical capabilities, easier integration across the care continuum, and a better experience for physicians and patients alike. That – and many other technologies – will be on display at Meditech booth #1360 in the Sands Expo.
At the booth, Meditech will showing its wares at work, with a series of demonstrations focused on population health, revenue cycle, care coordination, patient safety, physician experience and more. Physicians, nurses, CMIOs and other C-suite execs from clients who have adopted the Web EHR – Avera Health, Beaufort Memorial Hospital, Northwestern Medical Center, Steward Health and others – will be on hand to show how they use the technology in practice.
Specific use cases will include predictive surveillance for sepsis prevention, personalization of physician workflows, automated claims management, use of mobile apps for improved patient experience and more projects that can be tackled with help from its Meditech-as-a-Service platform.
In addition to all the news around its Web EHR, Meditech has recently announced some other important projects and partnerships (with more sure to come at HIMSS18). Earlier this month, for instance, it announced a new collaboration with pop health company Arcadia Healthcare Solutions, through which it will integrate new data into the Web EHR, merging Meditech's enterprise clinical database with claims and other data (including information from other EHR vendors) from Arcadia.
And this past summer, it announced that it would start offering its interoperability capabilities to clients this year. As a partner with HL7's Argonaut Project, Meditech will be among the first CommonWell members to deploy its FHIR specifications to healthcare customers, including find and retrieve document resources.
In addition to all the action at its own booth, Meditech will be demonstrating those data exchange capabilities and others – including including its participation the Nationwide Care Transitions use case with Commonwell Health Alliance – at the HIMSS18 Interoperability Showcase.
Meditech will be at Booth 1360.
An inside look at the innovation, education, technology, networking and key events at the HIMSS18 global conference in Las Vegas.
When Kate Sheridan was 11 years old, a series of complications from Lyme Disease changed her life dramatically.
“I went from a straight A student to not being able to read and write, a competitive athlete to wheelchair-bound, and developed an intense pain disorder,” she said. “We very suddenly had a lot to manage — medication schedules, dozens of doctor appointments and conflicting diagnoses, school accommodations, medical equipment — all of it was important, and all of it was overwhelming. We hit a low point where we had no way of controlling or even keeping up with what was happening; the whole situation seemed hopeless.”
Kate’s mother Kristina is a department head and researcher at the MITRE Corporation.
“As Kate's Mom and caregiver, I manage her care, advocate on Kate's behalf, coordinate between each of her doctors, and lay out the method we developed to communicate effectively and consistently with her medical team,” Kristina Sheridan said. “Kate's younger brother Ben was also sick at the same time, so we made sure the system we set up worked for them both. This experience made me realize how hard it is to manage complex, chronic conditions, and how little support or tools exist for chronic patients and their caregivers.”
Kate is now in remission and about to graduate from George Mason University, with a degree in health administration and policy.
Kate and Kristina have several suggestions for how to make healthcare work better for patients with chronic conditions. For one, Kate said, the industry needs to recognize that being a patient or a caregiver is hard work — and no one is born knowing how to do it.
“I compare learning the process of managing your data and engaging in bi-directional communication as similar to learning a new language,” Kate said. “We would never expect someone to be able to learn how to speak French immediately with no background and while under intense stress. It takes technology, education, and practice. We need better tools to make the language of data and empowerment accessible to all — this is where health IT has the opportunity to make a real difference.”
Kristina said another thing the industry can do is invest as many resources in care outside the clinical setting as inside it.
“Patients spend the majority of their time outside the clinical setting managing their illness by themselves, and yet we invest the vast majority of health IT funds in tools for the clinical environment,” Kristina added. “To truly empower patients, we need to invest in tools that will ease the burden of their illness on a daily basis and help them capture their input in real time, as they think of it, rather than expecting them to remember a month of changes during their appointments.”
But most importantly, if institutions want to improve the patient experience, it starts with listening to patients.
“We often think of patients as recipients of care, as people to take care of,” Kristina noted. “We forget that they are experts in how they feel, how their illness impacts their lives, and why they are unable to follow a certain treatment plan. Include these experts as consultants when designing a system or process. Ensure the inclusion of a diverse set of patients so the solutions are comprehensive and inclusive.”
At HIMSS18, Kate and Kristina Sheridan will share their story of how they overcame those difficulties and what lessons that story has for those working in healthcare. In addition to their personal experience, the Sheridans will also share results from a number of surveys and studies Kristina has embarked on at MITRE, inspired by their experiences.
Kristina and Kate Sheridan will be speaking in the session, “Democratizing Patient Data: A Story of Patient Empowerment,” at 1 p.m. March 8 in the Venetian, Palazzo K.
An inside look at the innovation, education, technology, networking and key events at the HIMSS18 global conference in Las Vegas.
What does Leidos mean by “optimizing EHR investments?”
It’s about leveraging your good technology investments to realize great results. It’s finding better ways to manage your cash flow and refocusing your business perspective on care delivery to improve the quality of care, outcome of care and cost of care. With the catalyzed adoption and deployment of EHR systems across the spectrum of healthcare enterprises, providers now have huge databases of important, patient-specific information that they can use to optimize care. If transitioning from paper to electronic was the first step in EHR development, selecting the appropriate tools and solutions to enhance that initial investment follows suit.
But beyond technology, optimization should encompass a broader approach, striving to make an organization’s people, process, and technology as effective and efficient as possible. Ultimately, that creates clinical value and improves patient care.
What’s driving organizations to prioritize optimization programs?
First, moving beyond the era of meaningful use. For years, healthcare systems were under an enormous burden ― driven by the federal stimulus and regulatory efforts ―to invest and implement large-scale EHR solutions. With nearly 85 percent of the market having largely implemented their core EHR solution, the next logical step is to examine post-live EHR optimization. Many organizations have not seen the results in improved efficiency or reduced cost of care that an integrated EHR can offer. Optimization initiatives can help them realize the best ROI possible.
Second, the goal of interoperability. As alternative payment models and population health requirements become part of the equation, thick systems integration can yield analytics to drive clinical, financial and operational decision-making. The Leidos team continues to incorporate market trends such as population health into its toolkit of content and workflows for system deployment and optimization.
Why should a health system look to a platform-independent provider to implement or optimize its EHR?
Our value in the marketplace is defined by our ability to be objective in solution selection and having a deep bench of experts knowledgeable in all current and competing systems as well as our clinical and business operations knowledge. When we work with our clients, either in commercial or federal health systems, our role is to be an independent, unbiased advisor. We scan the marketplace for solutions, study the client’s unique requirements, and then recommend a choice that aligns best with its needs. Our ability to stay objective comes from the detachment of not having built the EHR. Within every EHR there are multiple ways to complete the work in the system. The expertise of our staff provides us with the opportunity to advise on the system design that will best meet the needs of that organization.
Is there crossover between your deep federal experience and the commercial healthcare sector?
Absolutely. Leidos is a leader in providing technology-based solutions to complex problems, with nearly 30 years of experience with Department of Defense EHR solutions. Recently, commercial enterprises have recognized our work with the DoD and other federal agencies. There is an understanding that our expertise in delivering flexible solutions that support optimal care for federal customers can be translated to the commercial sector. When healthcare providers need to add new capability to their system ― say revenue cycle or population health analytics ― they contact us based on the efficacy of those federal implementation projects. It’s a very similar process in both markets. Whether in a commercial or federal setting, our value is our ability to remain objective and to be knowledgeable of the organization’s mission and objectives.
EHR implementations are notoriously difficult. How has Leidos managed to be so successful in this area?
First, it’s the experience that comes from being a Top-10 healthcare IT provider and the largest federal systems integrator in the country. We’ve seen it all. Second, across all of our service delivery models, we focus on selecting the appropriate pre-go-live team that can both relate to the processes and workflows taking place and determine how to best translate them across the continuum of care to our clients.
One of the most challenging steps in any enterprise deployment ― whether it’s an EHR or CRM system ― is change management. We have to consider an element of human nature in these deployments: “Whether I hate or love the current system, at least I know it. The new system? I don’t know it.” Our job is to help clients move up the learning curve and beyond frustration as quickly as possible. This involves coaching and information sharing, and setting expectations, as well as helping providers understand how they will perform their job using this new capability and walking them through those steps.
Beyond technology, optimization should encompass a broader approach, striving to make an organization’s people, process, and technology as effective and efficient as possible.”
- JERRY HOGGE, LEIDOS
Leidos is a Fortune 500® science and technology solutions and services leader working to solve the world’s toughest challenges in the defense, intelligence, homeland security, civil, and health markets. The company’s 32,000 employees support vital missions for government and commercial customers. Headquartered in Reston, Virginia, Leidos reported annual revenues of approximately $7.04 billion for the fiscal year ended December 30, 2016. For more information, visit www.Leidos.com
xG Health, a startup that came out of Geisinger Health System, worked with Epic to make its xG Intelligent Care Management became available in Epic's Healthy Planet software in February of 2017. And now the organizations said they are partnering with hospitals to both provide them with clinical content and to drive quality measures and improve clinical workflows within Healthy Planet.
The company said the latest hospitals to join the work using xG Health’s content, analytics and care management software are UCHealth in Colorado, Catholic Health Services of Long Island, Driscoll Health Plan in Texas, Legacy Health, and Southcoast Health Network.
Deborah Allwes Largoza, vice president of operations at Southcoast in Massachusetts and Rhode Island, said in a statement that it chose xG Intelligent Care Management for its evidence-based clinical content and its ability to meet NCQA/PCMH requirements. Another factor was xG’s native integration into Epic's Healthy Planet population health platform.
Once xG Intelligent Care Management is loaded into Healthy Planet, it becomes embedded in care manager workflows in both Epic’s Hyperspace and the Healthy Planet Link portal, according to the company. Healthy Planet then suggests assessments and best practices based on a patient's clinical condition that clinicians, in turn, can use to suggest goals and tasks for the patient's care plan.
“Evidence-based care management content is essential for the delivery of reliable, high-quality population health services,” xG Health CEO Earl Steinberg, MD, said in a statement. “xG’s EHR-embedded content helps care managers have up-to-date, best clinical practices, to optimize patient outcomes quality scores.”
One of the biggest challenges facing providers who want to deploy precision medicine at the point of care is the changes it requires for physician workflow. A new partnership between Edico Genome and InterSystems hopes to help with the movement of genomic data across clinical settings and electronic health records.
Deployed with InterSystems' HealthShare platform, Edico's DRAGEN Clinical Genomics Information System will help clinicians more easily order genomic tests – and will enable better analytics as such data is moved across the EHR.
Patients' genetic information can be shared bidirectionally, officials say, enabling harmonization of the massive amounts of genomic data generated by next-generation sequencing – ensuring that critical info is well integrated when physicians review the EHR and allowing clinicians to make more confident precision medicine decisions based clinical and phenotypic context.
"By ensuring connectivity between a patient’s genomic testing and their longitudinal health record, this partnership will give clinicians and patients alike better visibility into their complete health," said Paul Grabscheid, vice president of strategy for InterSystems, in a statement.
InterSystems' Health Connect interoperability technology aims to offer high-volume transaction support and continuous monitoring for clinical data. Edico Genome's CGIS is a comprehensive clinical genomics system designed to enable clinical labs to quickly and efficiently develop laboratory-developed tests.
"Our goal is to make it as simple as possible for labs of all sizes to start using NGS in routine clinical care," said Pieter van Rooyen, CEO Edico Genome in a statement. "Through our partnership with InterSystems, we are able to integrate DRAGEN CGIS into the broader healthcare ecosystem day-to-day workflow and operations, enabling patient’s genetic and clinical data to be reviewed together and potentially leading to richer insights."
Change Healthcare announced InterQual AutoReview, a software-as-a-service tool that can be used to automate parts of the medical review process.
Change showed an early version of InterQual AutoReview last year at HIMSS17 and will be publicly demonstrating the product, now generally available, at HIMSS18 in Las Vegas.
The company said InterQual AutoReview enables clinicians to submit an order with their EHR workflow and the cloud-based service creates a medical necessity review and, in turn, synchronizes with the case management system.
Change added that it worked with Christiana Care Health System in Newark, Delaware to conduct beta testing of InterQual AutoReview before releasing the final version.
That testing aimed to help clinicians admit patients properly to the emergency department.
“If we can fully automate even a third of our medical reviews, that would be a substantial boost to our admission utilization management efficiency,” Christiana Vice President of Care Management Patty Resnik said in a statement.
Change will be in Booth 4202 at HIMSS18.
Tiny, 11-bed Pagosa Springs Medical Center, based in Archuleta County, Colorado, doesn't have a lot in the way of technology resources and staff.
"I've got one IT guy and four informaticists," said Michelle Flemmings, MD, the hospital's chief medical information officer.
But the facility is extremely important to residents for miles around, and accomplishes quite a bit with those limited means.
"We are a critical access hospital," she said. "Our closest referral center is 50 miles away – an hour by ground. That's a Level III trauma center, we're a Level IV trauma center with expanded scope because we do orthopedics. We don't do OB, we don't do ICU, we don't have a cath lab.
"All of that has made us have to be very efficient in how we see patients and how we transfer patients – especially when we're talking trauma, sepsis and pediatric kids who need extra services," Flemmings said.
But until fairly recently, "every single thing was on paper, with the exception of the clinic and finances," she said.
In 2014, Pagosa Springs Medical Center went stem to stern with Cerner. That's changed everything.
"What we love about it is that everybody is working from the same record," said Flemmings. "So the one record can be the source of truth for everyone from billing to the clinic. That's very, very nice."
After hospital staff recovered from the initial shock of, 'Wow, everything we needed is right where we thought it should be and accessible,'" she said, "we decided to start playing a little bit with the data."
So much data. With everything discrete, digitized and at their disposal, the clinicians were excited to dig in.
"At first we wanted to look at every single thing, like a kid in a candy store," said Flemmings. "But then we decided to get down to brass tacks and focus on what's important."
That meant making the most of its data – homing in on sepsis, CVA and other critical indicators from its EHR to assess relevant KPIs and use them to improve the efficiency and safety clinical workflows.
"The first thing we went for was the low-hanging fruit – like door-to-doc time," said Flemmings. "We knew that we were about 30 or 35 minutes, initially. And looking at the EHR what we've been able to do is change around everything – except the doc staffing, interestingly enough. We've added more registration clerks in order to have bedside registration become the rule rather than the exception."
Thanks to those insights, the hospital's door-to-doc time is averaging between six to eight minutes for the past several quarters, she said.
That's a marked improvement from even a year ago.
"We were actually just playing with the data again because we're going to have a HIMSS Stage 7 evaluation in February," said Flemmings. "A year ago, in January, we were somewhere about 18 minutes, which according to The Emergency Department Benchmarking Alliance is fantastic for our size. And now we've taken that and cut it in half again, to about eight minutes."
Another insight gleaned from the new EHR data?
"We figured out that, based on the volume curve at registration, we needed to have a nurse that bridged the evening into the night shift: That way the night nurse could be better able to process through the patients," she said. "As the volume curves changed and showed that we started having peaks later and later into the evening and then into the night, we were able to justify the fact that we needed to have an FTE for a nurse overnight, every day of the week. That works beautifully. We don't have any log jams or prolonged lengths of stay for night patients versus day patients."
Making sure patients are being taken care of promptly and efficiently, and getting them to where they need to be, is paramount at a hospital such as Pagosa Springs.
"We are our own backup," said Flemmings. "We needed to be certain about what we were doing to get patients from point A to point B, and then either admitted to our hospital onto a tertiary care hospital happened as quickly and safely as possible. The EHR has certainly gone a long way toward that."
Beyond the low-hanging fruit, clinical staff has also been able to make more advanced data-driven improvements.
"We started looking at things like our CVA turnaround time, based around the MINS criteria. We're doing well with that. There's only one month, I think, this past year it looked like our time for getting patients into the hospital, looked at, and back out, that creeped up a little bit and we're starting to look into what happened. My thought is that it's more patients. Since 2014, we've gone from seeing about 2500 patients a year to now seeing 8300. So I think it’s a numbers issue, really, as to why that's happening, as opposed to inefficiencies or our guidelines.
"Then we looked at sepsis and troponin turnaround times – docs were concerned that it was taking an inordinate amount of time for the labs to come back," she added, and the hospital has been able to make targeted improvements in those areas too.
“We are exquisitely rural,” she said. “Anyone who's ever worked in that kind of environment understands that rural, yes, has guidelines, but it's just so very different because of resources – or lack thereof."
In situations like those, where every budget allocation, FTE deployment or new workflow tweak can improve safety and efficiency, smart analytics performed on the right data can make a huge difference.
Flemmings will be speaking in the session, “By The Numbers - Leveraging Your Clinical Analytics Data,” at 10 a.m. March 8 in the Venetian, Palazzo D.
Two years ago, Dell and EMC made headlines for completing one of the largest tech mergers in history, the $67 billion acquisition by Dell of EMC’s cloud computing and big data business.
Now, at HIMSS18, Dell EMC will be demonstrating how companies can make digital transformation a reality in such arenas as accountable care and the EHR.
“Our focus is under four initiatives: health IT, precision medicine, connected health and security transformation,” said Roberta Katz, director of Global Industries. “We will have demos based on our four pillars, based on the healthcare cloud. We’ll be demonstrating virtual reality.”
Many clients are still spending a lot of time on their clinical applications, Katz said. Hospitals can have 500 or 600 applications and want to know how to streamline those and become more efficient.
“The way they do it is around infrastructure,” she said.
This can be a multi-cloud environment for a business application or clinical application.
Dell EMC is also working on projects around precision medicine, genomics and managing risk. This includes working with independent software vendors on clinical applications, EHRs and working with clinical partners to build apps for healthcare exchanges.
“As part of our value proposition, we have a significant set of healthcare partners,” Katz said.
Dell will be in Booth 3613.
eClinicalWorks announced that it will launch new cloud-based services for acute care EHR settings and revenue cycle management at HIMSS18 next week.
The platform is designed to create a “unified EHR,” with a seamless workflow to share data between ambulatory and acute care settings, officials said in a statement. The acute care EHR includes a wide range of capabilities from CPOR data to infection control and referrals management.
The tool will start at $599 per bed, per month, with no upfront charge for licensing, which eCW CEO Girish Navani said will ensure hospitals “have no financial barriers to transition to eCW.”
eCW also announced that Texas-based Hamilton Healthcare System, a 42-bed community hospital will be the first to go live with the new tool later this year, expanding its current relationship.
According to officials, the tool was designed with guidance from clinicians and will give Hamilton clinicians with a dashboard that shows all clinical details for the inpatient and emergency departments, as well as the operating room.
“It’s always been our goal to have one unified EHR,” Hamilton Healthcare CIO Chad Reinert said in a statement. “As a small community hospital, we concluded that a progressive unified EHR for inpatient, ER and ambulatory settings simply was not available for a cost that we could afford.”
eClinicalWorks is in Booths 145.
A bipartisan group of U.S. Senators – Elizabeth Warren, D-Massachusetts; Michael Bennet, D-Colorado; Dean Heller, R-Nevada, and Pat Toomey, R-Pennsylvania – introduced a bill on Feb. 27 that seeks to harness health IT to help combat the opioid crisis.
The Every Prescription Conveyed Securely Act would mandate electronic prescriptions for all controlled substances under Medicare.
"We need to be using every tool at our disposal to fight the opioid epidemic," said Warren in a statement, noting that EPCS would "help gather better data on the opioid epidemic while also helping health care providers make the best decisions for their patients."
A recent Department of Justice report found that misused prescription opioids are often obtained illegally using forged or altered prescriptions and by consulting multiple doctors. It also determined that most prescription fraud remains undetected.
The EPCS Act seeks to reduce the number of opioids obtained through such phony prescriptions and prevent doctor shopping. The legislation would direct health care providers to use electronic prescribing for controlled substances for Medicare Part D transactions beginning in 2020.
"An epidemic of this magnitude requires us to address all aspects of the problem, starting with how providers prescribe opioids," said Bennet. "This bipartisan legislation would expand a critical tool to track the use of opioids, ultimately reducing overdoses and saving lives."
Companion legislation, H.R. 3528, was introduced in the House of Representatives by Congresswoman Katherine Clark, D-Massachusetts, and Congressman Markwayne Mullin, R-Oklahoma.
On the cusp of HIMSS18, Carequality gave an update on the progress it has made in the past year-and-a-half.
“We’ve gone from concept to critical mass,” said Carequality Vice President Dave Cassel. “The speed with which this has occurred isn’t something we’re accustomed to from interoperability projects, historically.”
Results: More than 1,250 hospitals, 35,000 clinics, and 600,000 healthcare providers connected via the Carequality interoperability framework are now exchanging nearly 2.5 million clinical documents every month.
Nine Carequality members are exchanging records today: athenahealth, eClinicalWorks, Epic, GE Healthcare, Netsmart, NextGen Healthcare, OneRecord, Santa Cruz HIE and Surescripts.
Cassel credited the participants for having done the hard work of getting their members and customers wired in. “It comes down to trust,” he added, “which stems from the contractual governance, but is validated through solid onboarding processes.”
In addition to the regional health information exchange, record locator service, personal health and EHR vendors live now, 18 other organizations have signed on to be implementers of the Carequality framework. Those in the onboarding process now include new kinds of service providers, consumer apps, and additional EHR vendors and HIEs.
Carequality will be in Booth 3374.
Telmediq has added a new call center console to its secure communications platform, enabling operators at health systems to manage inbound calls while accessing data from clinical IT systems in real time.
The technology, which can integrate with Epic, Cerner, and Meditech electronic health records, allows call center agents join virtual queues to take inbound calls from patients and clinicians and allows them to contact clinical staff with secure text.
Telmediq officials noted that, historically, on-premise call center software would need to be integrated with third-party paging or texting solutions. This new tool brings all of the mobile communications into a single platform.
The new console also allows hospitals to record operators and produce detailed reporting; analytics capabilities in the system measure call types and message flow, allowing managers to better allocate staff.
The company plans to add a patient texting module to the platform later this year, giving operators the ability to field inbound secure text messages and route them to the right hospital staff, helping drive improvements in patient engagement and experience.
"Hospitals continually struggle to get their legacy CTI-based call center technology properly integrated with their directory, scheduling solutions, patient records and texting solutions," said Telmediq CEO Ben Moore in a statement. "This creates a lot of inefficient workarounds by call center staff and IT. The key to improving communication in hospitals is removing those silos and connecting all communication channels."
Telmediq is in Booth 3073 st HIMSS18.
Primary care providers spend more time working with their electronic health record systems than they do looking at patients during visits, according to new research published in Family Medicine.
Researchers performed an observational study of family physician residents, attendings and ambulatory patients across 982 clinic visits, associated with 10 Residency Research Network of Texas (RRNeT) residencies from May to June 2015.
They found family providers spend about 18.6 minutes on clinical documentation in the EHR, but about 16.5 minutes on face-to-face interaction with patients. The length of time spent on a patient visit was more for the number of reasons for the visit, new patients, number of medications and the like.
The time breaks down to about 3 minutes working in the EHR before entering the exam room, 2 minutes working on the EHR in the room, 7.5 minutes of non-face time, or primarily EHR time, and another 6.9 minutes of EHR work outside of normal clinical hours.
Even worse, more 64 percent of visits involved EHR work outside of office hours. And 73 percent of the visits had physicians working with the EHR in the exam room.
“We found that family physicians spent more time in direct ambulatory patient care working in the EHR than they spent in face-to-face time with their patients,” the researchers wrote.
But even worse, the majority of providers worked through lunch, stayed late or took their work home with them to complete the EHR work from the day.
The researchers noted their results are similar to a recent study that found providers logged an average of 3.08 hours for office visits and 3.17 on the computer each day. However, the results contrast a recent U.K study that found providers spent 9.5 minutes with patients during a visit, compare to 3.3 minutes on the EHR.
“The UK results are consistent with observed consultation times across six countries in Europe in 2002 of 7.6 to 15.6 minutes total (overall mean, 10.7 minutes),” the researchers wrote. “Our results imply that U.S. family physicians spend more time working in the EHR than their European counterparts spend in the entire visit.”
These results aren’t surprising, as there have been multiple studies that gauged the number of time providers spend on EHR work, compared to time with the patient.
A 2017 study in the Annals of Family Medicine found providers spend nearly six hours on EHR data entry during an 11.4-hour workday. This extra time has often been criticized for contributing to physician burnout and a work-life imbalance.
University of Missouri Health Care announced that it will roll out revenue cycle management technology from Cerner.
Under the agreement, Cerner will help manage revenue cycle performance across the university’s five hospitals and more than 50 primary and specialty care clinics.
MU Health Care is also poised to integrate Cerner’s registration, scheduling, patient accounting and practice management solutions and transaction services with its existing Cerner Millennium EHR, officials said.
The integration of clinical and financial data is designed to help clinicians and staff update the billing process throughout a patient’s visit in order to improve clinical documentation, boost reimbursement and reduce claims errors, according to Cerner executives. The technology is expected to streamline billing for both staff and patients.
MU Health Care CEO Jonathan Curtright said that deploying the revenue cycle tools also advances the system’s enterprise transition to Cerner Millennium. MU Health Care’s transition to one integrated system will provide clinicians access to one complete digital record of their patients’ health history, including clinical and financial data.
Cerner and MU have partnered in the past to form the Tiger Institute for Health Innovation with the goal of transforming healthcare.
MU CIO Bryan Bliven and Thomas Selva, chief medical information officer of MU Health Care will be speaking in the session, “A multi-pronged approach to improve provider satisfaction,” at 1 p.m. March 7 in the Venetian, Murano 3304.
HIMSS18 will be a pivotal one for Cerner in many ways. It’s the first with new CEO Brent Shafer, who has big shoes to fill as the first outside hire to lead the company since founder and longtime CEO Neal Patterson passed away last summer.
And it comes as the company has arguably more big projects on its to-do list than ever, including the massive ongoing MHS Genesis project for the U.S. Department of Defense and the upcoming contract with the Department of Veterans Affairs– to its continuing innovation on any number of fronts, from consumerism to the cloud, interoperability to artificial intelligence.
"Recently, Cerner and Apple worked together to make personal health information accessible on a consumer platform, and we’re working with a range of partners and clients to turn up the heat on the conversation about interoperability," Cerner President Zane Burke said. "We’ll showcase our collaboration with Apple to make health records available at your fingertips in the Apple Health app.”
Burke added that Cerner will also be offering a look at virtual health solutions that empower individuals to manage their health via telemedicine and remote monitoring technologies as well as intelligent solutions for hospitals as they adjust to rising costs and value-based care.
"We’re at a pivot point with the digitization of health information, and we are redefining the idea of 'care.’” Burke said. “We're moving from managing patient encounters to providing for the well-being of populations.”
Cerner is particularly focused on the growing clout of the healthcare consumer and is committed to activating and engaging patients to be more proactive in their own health. Central to this work is the agility and speed offered by cloud technology, and Burke said Cerner continues to work with leading companies in industries other than healthcare to build on its own cloud-based offerings.
Cerner's founding membership in the CommonWell Health Alliance – which was first announced five years ago at HIMSS13 – is one way to help innovate on the interoperability front, he said, and the company is committed to the co-creation of an open platform for innovation by leveraging FHIR standards through its work with the Argonaut Project.
More fluid data exchange, particularly with the DoD, was a major driver for the contract Cerner was awarded for the VA's new EHR this past June, of course. Although the contract is currently on pause while MITRE does an independent assessment of its specifications, Burke said the VA project ultimately will "not only create seamless care for our nation's veterans, it will also fundamentally change interoperability in the commercial healthcare space — something we are very excited about."
Population health management is another imperative in the era of value-based reimbursement, and it's another area "where Cerner continues to grow," he said. "Providers need data that is actionable at an individual and community level to improve care. Cerner is uniquely positioned, through our cloud-based platform HealtheIntent, to pull all those data points together, aggregate and normalize the data and feed it back into the workflow for clinicians to act on."
And analytics to help mine that data for the most useful insights are fast-evolving too – largely driven by lightning-fast advances in artificial intelligence and machine learning, which "remain a key focus for Cerner," said Burke.
He pointed to early efforts such as the Cerner HealtheDataLab technology, which offers a secure environment where researchers and data scientists can "query de-identified data, extract and transform data sets in research-ready formats, build complex models and algorithms and validate findings in a single elastic environment."
Cerner is in Booth 1832.
Health Catalyst introduced Touchstone at HIMSS18 and, in so doing, described it as a performance discovery, prioritization, benchmarking and recommendation tool.
“Touchstone is built from the ground up on the latest AI and software from Silicon Valley,” said Dale Sanders, President of Technology, Health Catalyst. “Touchstone's recommendation engine, which borrows from Amazon and Netflix, gives you not just comparative benchmarks but recommendations to improve your performance against benchmarks."
The technology includes risk models based on artificial intelligence and anomaly detection algorithms that hospitals can use to pinpoint underperforming areas. Touchstone performs risk-adjusted benchmarking by culling data in claims, cost-accounting systems, EHRs, external benchmarks and operations to risk-adjust benchmarking, to “guide users to the data and analyses of greatest relevance to their work and to the organization's goals,” the company said.
Sanders said that in addition to aggregating Health Catalyst’s client data, which comprises more than 100 million patients, Touchstone gleans other data sources, including the Centers for Medicare and Medicaid Services, state’s all-payers claims databases, genomic information and self-reported data.
Detailed AI and machine learning analytics pinpoint factors creating performance issues and the recommendation list Touchstone produces can include opportunities to improve based on clinical, financial and operational considerations.
"With data, all things are possible,” Sanders said. “If Touchstone lives up to its full potential, we humbly believe that it could become a national asset for better understanding of both population health and precision medicine.”
Health Catalyst is in Booth 1332.
Cerner’s EHR project for the U.S. Department of Defense has already led to increased clinical efficiencies and reductions in duplicative testing for some sites part of the initial pilot, according to a new blog post from Travis Dalton, general manager of Cerner’s federal division.
In February 2017, DoD rolled out the first MHS Genesis EHR at Fairchild Air Force Base in Washington, followed closely by implementations at Naval Hospital Oak Harbor and Naval Hospital Bremerton. The last pilot site went live at Madigan Army Medical Center in October.
Currently, the project is in a planned eight-week assessment period to work through all of the kinks that happen with most EHR projects. To mitigate some of these issues, Dalton said DoD has leaned on commercial practices of deployment.
This includes rolling out the EHR incrementally and focusing on a smaller set of facilities first before rolling out at all sites, as a way to “work through issues and make adjustments to make the larger outcome better.”
Dalton said Cerner has worked closely with the agency to properly train users and make sure clinicians are accustomed to the new platform. But as expected with a project of this size, the rollout has seen its challenges.
“Some early adoption issues mean that change management and governance processes are being refined,” Dalton wrote. “Some issues logged have taken longer to resolve than we would have liked, and productivity at the local level has taken some time to normalize.”
“The incremental approach anticipates these types of early concerns as a part of the deployment process and integrates steps to examine issues and develop long-term resolutions prior to full enterprise rollout,” he added.
Despite these challenges, the DoD has already seen some positive results.
Fairchild achieved HIMSS Analytics EMRAM Stage 6, which demonstrates the provider is effectively leveraging the functionality of its EHR. Further, Madigan has reduced the average stay for hospital patients experiencing sepsis by 37 percent, by leveraging early recognition of sepsis risk alerts.
In addition, the pilot sites canceled 2,613 non-medication orders from June 2017 to Jan. 2018, which potentially reduced the number of duplicative procedures like imaging and labs. In the same tired, the sites decreased the time spent placing orders for each patient by about 8 percent.
“These early successes prove we are on the right track, but our job is never done and pursuit of improvement will never cease,” Dalton wrote.
In January, DoD Defense Healthcare Management Systems’ Communications Director David Norley told Healthcare IT News that the assessment period will conclude in May, and the EHR project will go into a critical review phase -- the final step to the project.
At that time, leaders from all four test sites will gather to approve the parts that are working, and get rid of what doesn’t.
The Cerner project will serve as a model for the Department of Veterans Affairs’ own EHR implementation. That contract is expected to be signed soon.
Consumer behaviors have dramatically changed the healthcare landscape, and expectations of technology are at an all-time high. We are living in a time when technology is rapidly transforming our quality of life. Following the trend of other industries, health information will become more intelligent, easier and more natural to use. Providers and consumers need streamlined, adaptive workflows that are "aware" of all factors — clinical, social, environmental and geographic — that affect health and personal engagement.
Major consumer brands are investing heavily in healthcare, but this is a complex industry and it will take experience and collaboration to deliver on the health IT infrastructure Cerner has helped pioneer.
Consumers are looking for additional points of contact with their healthcare providers and easier access to their health information. The future of health IT relies on forming a personal connection with consumers and creating a sticky experience that helps providers become trusted partners in their health and wellness journey.
It all starts by creating smarter care within.
Continuous advancement through smarter care
Everyone wants smarter care — we all want better health outcomes, we all want to be as healthy as we can be and we all want to be as close to home as possible. Smarter care is about the use of actionable health information to drive meaningful outcomes and improve a person's health status.
Smarter care isn't just about helping improve individual health outcomes. It can also reduce costs and streamline operations for healthcare providers. Smarter care will help anticipate providers' needs as the industry consolidates, regulations change and reimbursement models shift. With the addition of market drivers like value-based care and economic factors that influence how consumers engage in their health decisions, there is room for providers to reduce inefficiencies and anticipate future needs throughout the healthcare system.
The effective use of data also relies on an appropriate infrastructure in all care settings, including rural community hospitals. It's important to tailor our platform to the unique needs of each client, which for Cerner means employing on-premise data hosting, remote hosting, as well as public and private clouds.
Healthcare's shift to hybrid cloud environments in recent years has been fascinating, with many successes found in rural, small, independent hospital settings — a traditionally underserved segment of the industry. While these community, critical access and specialty hospitals certainly face a unique set of challenges, they have displayed a strong propensity to leverage healthcare technology to improve clinical and financial outcomes.
This may be best evidenced by the recent announcement of Pagosa Springs Medical Center, an 11-bed critical access hospital in rural Colorado, having just achieved Stage 7 of the HIMSS Electronic Medical Record Adoption Model to better serve their community.
We also looked to the cloud in creating HealtheIntent, our population health management platform that pulls information from disparate sources into one longitudinal record that spans the individual's care experiences.
Creating intelligent experiences
Smarter care involves creating intelligent experiences. The raw power of health data must be leveraged to uncover insights that help improve the health of the individual and the community.
As intelligence and machine learning continues to advance, they will provide a wider array of treatment recommendations as well as streamline routine tasks like clinical documentation. Over time, the provider will continue to gain meaningful insights to improve care each day. While the full potential of machine learning and cognitive assistance lies in the future, the benefits of intelligence can be leveraged now by the provider to create a more efficient workflow and a more personalized, smarter experience.
One of the most crucial factors contributing to smarter, patient-centric care is interoperability. If we boil interoperability down to its essence, it answers this simple question: "Can I have my record?" The answer to this should be a resounding "yes" for all healthcare providers. Consumer-directed health records empower consumers to take an active role in managing their own health. Unifying multiple platforms and data sources across the continuum creates one record, one plan and one bill, giving consumers their health information in one place, regardless of where they receive care.
A standards-first approach to data sharing is the only way forward. Health IT companies and providers working together facilitates easy data sharing through APIs. This approach not only improves interoperability across platforms, but it encourages innovation. Open APIs in health care are ripe for software developers to build robust applications to create more consumer-friendly experiences and smarter workflows for doctors. Innovation begins with the ability to share, and the industry is making progress toward the free flow of data securely across multiple sources.
Smarter care and consumerism are intertwined in the evolving healthcare landscape. The industry shift toward value-based, consumer-centered care is nascent, but it is already influencing every corner of health IT development. Providers must become data-driven organizations, offering smarter care that engages the consumer and streamlines their operations. This will be no easy task, but we have the technology, the desire and the resources to improve health care for every person. With this strong foundation, intelligence and machine learning will create a more personalized consumer experience and move the needle on systematic, preventative care.
Working to provide smarter care and better outcomes is who Cerner is at its core. No longer will consumers receive fragmented care that results in costly treatments; instead, smarter care will lead to individualized healthcare experiences that prevent disease before it takes hold. This next phase of health care depends on finding new ways for individuals to take an active role in their wellness, while continuing to advance care delivery and outcomes – it's time to provide smarter care.