Review and comparative analysis of the OpenVistA electronic health records (EHR) system for your facility as per your RFI request. This report will form the foundation for recommendations to the OpenVistA EHR for Accountable Care Organizations (ACOs) that are interested in investing and implementing EHR technology. In addition, the comparative analysis of OpenVista EHR system will be supported by insight from Meaningful Use metrics and the findings of interviews conducted with stakeholders with your ACO.
Kristin Stillman is a system administrator and desktop support technician seeking a new position. She has 10 years of experience in hospital settings, providing technical support and leading projects. She is skilled in Windows 7, electronic medication dispensing systems, and various clinical applications. Stillman has a background in pharmacy automation and technical support. She is pursuing a Bachelor's degree in Computer Science.
Treat EDPS as a Risk Adjustment program…not an IT function. This Episource presentation walks you through the 3 phases of EDPS, and key aspects to keep in mind to run a successful risk adjustment program.
Book of Pearls (BOP) is a clinical support application that integrates with Allscripts EHR systems. It aims to optimize EHR data entry and provide evidence-based diagnostics and reference materials at the point of care. BOP customizes data entry based on differential diagnoses and populates a table to facilitate clinical analysis. It strategically positions past patient information from EHRs to enhance risk assessment. BOP will partner with hospitals and be priced at $400 per user per month.
Senior Wellness Solutions has developed an automated system to deliver Medicare's Annual Wellness Visit (AWV) in a timely and cost-efficient manner. The system completes the AWV through an online health risk assessment, automatically provides all required preventive services and testing, and generates a personalized prevention plan and quality measures reports. The prototype has been used to complete over 400 AWVs. The system aims to increase AWVs among Medicare beneficiaries from the current rate of 7% by integrating with EHR systems and automating the billing process. It is estimated to generate $170,000-$400,000 in additional annual revenue per 1,000 patients for practices.
Allscripts is a large healthcare IT company that provides electronic medical record (EMR) and practice management solutions to over 5,500 clients including hospitals, physician practices, and post-acute facilities. They aim to connect healthcare providers through a single connected network and platform to share patient information. Implementing an EMR like Allscripts MyWay can help practices improve clinical outcomes and financial performance through increased safety, quality, and reimbursement while qualifying for federal stimulus incentives of up to $44,000 per provider over 5 years. Allscripts clients have reported reductions in call backs, improved billing and collections, and over $7 million in PQRI bonuses earned using Allscripts quality reporting tools.
Edifecs- How to ensure RAPS and EDPS submissions equal revenue successEdifecs Inc
This document discusses challenges health plans may face when transitioning from Risk Adjustment Processing System (RAPS) submissions to Encounter Data Processing System (EDPS) submissions. It outlines differences in the two submission formats that could lead to discrepancies and revenue impacts if not properly managed. The document provides a use case example of how to identify variations, ensure compliance, and reconcile RAPS and EDPS submissions. It concludes with a checklist of steps plans should take to successfully manage the transition.
This document describes a proposed data warehousing model and architecture for a medical center. It discusses setting up data marts and warehouses to store medical data from various systems to enable analysis and reporting. It outlines some goals like improving reporting, integrating different data sources, and facilitating trend analysis. It also notes some challenges around support, identifying reporting needs, and bridging technical and user needs.
Presented at the 7th Healthcare CIO Certificate Program, Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University on September 15, 2016
Kristin Stillman is a system administrator and desktop support technician seeking a new position. She has 10 years of experience in hospital settings, providing technical support and leading projects. She is skilled in Windows 7, electronic medication dispensing systems, and various clinical applications. Stillman has a background in pharmacy automation and technical support. She is pursuing a Bachelor's degree in Computer Science.
Treat EDPS as a Risk Adjustment program…not an IT function. This Episource presentation walks you through the 3 phases of EDPS, and key aspects to keep in mind to run a successful risk adjustment program.
Book of Pearls (BOP) is a clinical support application that integrates with Allscripts EHR systems. It aims to optimize EHR data entry and provide evidence-based diagnostics and reference materials at the point of care. BOP customizes data entry based on differential diagnoses and populates a table to facilitate clinical analysis. It strategically positions past patient information from EHRs to enhance risk assessment. BOP will partner with hospitals and be priced at $400 per user per month.
Senior Wellness Solutions has developed an automated system to deliver Medicare's Annual Wellness Visit (AWV) in a timely and cost-efficient manner. The system completes the AWV through an online health risk assessment, automatically provides all required preventive services and testing, and generates a personalized prevention plan and quality measures reports. The prototype has been used to complete over 400 AWVs. The system aims to increase AWVs among Medicare beneficiaries from the current rate of 7% by integrating with EHR systems and automating the billing process. It is estimated to generate $170,000-$400,000 in additional annual revenue per 1,000 patients for practices.
Allscripts is a large healthcare IT company that provides electronic medical record (EMR) and practice management solutions to over 5,500 clients including hospitals, physician practices, and post-acute facilities. They aim to connect healthcare providers through a single connected network and platform to share patient information. Implementing an EMR like Allscripts MyWay can help practices improve clinical outcomes and financial performance through increased safety, quality, and reimbursement while qualifying for federal stimulus incentives of up to $44,000 per provider over 5 years. Allscripts clients have reported reductions in call backs, improved billing and collections, and over $7 million in PQRI bonuses earned using Allscripts quality reporting tools.
Edifecs- How to ensure RAPS and EDPS submissions equal revenue successEdifecs Inc
This document discusses challenges health plans may face when transitioning from Risk Adjustment Processing System (RAPS) submissions to Encounter Data Processing System (EDPS) submissions. It outlines differences in the two submission formats that could lead to discrepancies and revenue impacts if not properly managed. The document provides a use case example of how to identify variations, ensure compliance, and reconcile RAPS and EDPS submissions. It concludes with a checklist of steps plans should take to successfully manage the transition.
This document describes a proposed data warehousing model and architecture for a medical center. It discusses setting up data marts and warehouses to store medical data from various systems to enable analysis and reporting. It outlines some goals like improving reporting, integrating different data sources, and facilitating trend analysis. It also notes some challenges around support, identifying reporting needs, and bridging technical and user needs.
Presented at the 7th Healthcare CIO Certificate Program, Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University on September 15, 2016
The Amazing Charts EHR system allows medical practices with 10 or fewer clinicians to completely document patient encounters. It includes features like charting, e-prescribing, scheduling, billing integration, and decision support tools. The software costs $2,395 per clinician for a license, and $1,195 annually for maintenance and support. Additional optional services like cloud hosting, offsite backups, and billing services are also available for monthly or annual fees.
This document discusses clinical quality measures (CQMs) that eligible providers must report on in 2014. It begins with an introduction to the speaker, Kintu Shah. It then provides details on the 9 CQMs that must be reported on for adult patients and the 9 for pediatric patients, including which domains they fall under. The document reviews resources for CQMs and provides tips for working with CQMs, such as understanding measure components and using appropriate encounter codes. It also discusses capturing information across visits and providers, issues with cancer staging, and improvements to the EHR system for supporting CQMs.
Why should a health plan invest in integrated solutions when providers have more to gain? How to remove the risks of moving forward without an industry standard? Safe harbor investment? Is an all-payer/all-provider solution even possible today? How do I justify an investment in workflow automation and backend system integration? This is a webinar on extension of the successful conversation on claims attachments raised at WEDI National 2016. Three healthcare vendors came together to discuss how to overcome key challenges by leveraging current investments in a multi-vendor model.
EON Systems' The Digital Office Version 5.0 electronic health record software received certification from ONC-ATCB as a Complete Ambulatory EHR. The software supports chiropractic, physical therapy, and multi-disciplinary practices. It received certification according to criteria adopted by the Secretary of Health and Human Services, supporting Stage 1 meaningful use measures to qualify providers for funding under the Recovery Act. The software certification number is IG-2658-11-0137 and was certified on October 25, 2011.
The document describes Cloudpital, an electronic medical record (EMR) software. It provides information on Cloudpital's features such as maintaining patient documentation, managing medication and problem lists, capturing clinical documents, and creating care plans. Cloudpital allows for flexible workflows and customizable templates. It also discusses Cloudpital's global offices, how it works in hospitals, advantages for users, and analytics capabilities. The document promotes Cloudpital as providing the best EMR solution.
This document provides an overview of Entrada, a healthcare technology platform designed to help medical facilities streamline clinical documentation workflows. It describes Entrada's core functions like automatically routing clinical information between scheduling, medical records, and other systems. The document also outlines Entrada's models for ambulatory and acute care, explaining how it generates work lists, routes dictations for processing, and returns completed documentation to electronic health records.
CHI Memorial's 2015 Year in Review document provides an overview of the hospital's accomplishments in 2015 and plans for 2016. Key highlights from 2015 include an increase in admissions and ER visits, improvements in quality metrics like patient safety and experience, expansion of cancer services, and 100th TAVR procedure. Plans for 2016 focus on infrastructure projects, expanding services, and technology transformations like upgrading communication systems and pursuing meaningful use of electronic health records.
This document provides an overview of Health Catalyst, a company that provides healthcare data warehousing and analytics solutions. It discusses Health Catalyst's mission to transform US healthcare using data-driven insights. The company offers an enterprise data warehouse, data integration tools, reports/dashboards, and applications for quality improvement, population health and predictive analytics. Case studies demonstrate successes in cost savings, core measure performance, and clinical outcomes.
mHealth Israel_Ben Echeazu_Highmark Health_ Startups Engaging with US PayersLevi Shapiro
Presentation by Ben Echeaz, Business Development Director, Highmark Health, March 25, 2019, for the mHealth Israel community: Startups Engaging with US Payers. Includes overview of the US Payerand health insurance sector, Relationship to Blue Cross Blue Shield, Challenges in addressing needs and gaps through Big Data technology, How Payers de-risk their reimbursement and coverage decisions with early stage startups, the role of Big Data in informing the movement toward value-based healthcare, Enterprise focus areas across 7 major applications: Diagnostic, Preventative, Precision Medicine, Adverse medication events, Cost reduction, Medical research Population health, etc. Highmark's VITAL has projects in the top 5 areas, these area are not mutually exclusive.
Value Based Care Model
Inadequate Evidence
Solution
Traversing “Valley of Death”
De-risking Reimbursement
Vital Innovation
Conclusion
Focus areas for evidence development
- Chart My Meds is a cloud-based secure medication list that is HIPAA-compliant and does not store PHI on servers. It has a low learning curve for both patients and providers.
- The medication list can be integrated with EHR systems to provide a consistent discharge medication list for improved care coordination across providers.
- The platform allows for dynamic paper and digital medication lists that can be easily shared and updated among all providers to aid medication reconciliation.
Enterprise systems in healthcare: leveraging what we know from other industr...CONFENIS 2012
Dr. Carol Brown - distinguished professor at Stevens Institute of Technology , The Howe School of Technology Management
enterprise systems in healthcare: leveraging what we know from other industries
Harness Your Clinical and Financial Data with an Enterprise Health Informat...Perficient, Inc.
The importance of Enterprise Health Information Exchange (EHIE) as a key way to empower your physicians and patients and demonstrate meaningful use of electronic health records:
- Present the business case for EHIE as an important architecture that matters to progressive health systems
- Take a look at some of the market-leading EHIE architectures and products
- Provide real exam...ples of organizations that are using EHIE to improve their operations
HySynth Clinical Data Repository is used for storing, integrating ,managing and reporting on clinical studies.
It enables pooling of clinical and nonclinical data from multiple sources into a single environment. Better regulatory compliance with comprehensive security, an audit trail, and traceability, More-informed decision-making through pooling and analysis of clinical and nonclinical data
CDR has been developed to revolutionize ability to:
- Address complex health authority questions quickly and completely
- Produce CDISC compliant submissions
- Review safety data in real-time, mine our overall database for scientific and commercial queries
At HySynth provide,
- Business case development and cost analysis
- Requirements and design management
- Best practice analysis and recommendations
- Installation and configuration
- Oracle CDA and LSH pilots and proofs of concept
- Hosting
- Oracle CDA and LSH implementation
- CDA and LSH validation
- CDA and LSH training
- CDA and LSH extension development
LST on the following applications
- Argus Safety Suite
- Oracle Clinical / Remote Data Capture (RDC) /
- Thesaurus Management System (TMS)
- Oracle Inform EDC / Central Designer / Central Coding
- Life Sciences Data Hub (LSH)
- Oracle Data Management Workbench (DMW)
- Oracle Clinical Development Analytics (CDA)
- Adverse Event Reporting System (AERS)
- SAS
PILSrx, from Procurement to Patient, how the Australian Defence Force maximis...Ocean Software
PILSrx is the Pharmaceutical Integrated Logistics software that is used by Australia's Defence Forces to manage the supply chain of all the pharmaceuticals procured by the ADF and distributed to personnel.
This presentation was recently delivered at the MILCIS 2017 conference by Ocean Software MD, Mr Bruce Moors.
I-Seha, National Health Information System, BahrainUNDP India
The Ministry of Health in Bahrain implemented a National Health Information System called I-Seha with Indra Company to improve healthcare services. I-Seha creates a paperless system that integrates clinical and administrative solutions across primary care, secondary care, and hospitals. Patient information is compiled into a single Electronic Health Record accessible anywhere. The goals of I-Seha are to enable quick health data sharing between professionals, unlimited access to health records across facilities, integrated medical services, availability of data for informed decisions, and improved quality of care through technology.
The document discusses several healthcare technology companies that provide solutions for exchanging clinical data and orders between healthcare providers. This includes aggregating and normalizing scattered clinical data from labs and diagnostic imaging to improve care coordination and population health management. The companies described offer electronic health record integration, a clinical data exchange hub, and tools to match individual patient or member data to facilitate care management.
The document discusses advanced tools and techniques in FileMan such as import/export of data between applications, relational navigation between files, computed expressions, use of FileMan functions, and system management features like standalone FileMan and alternate editors. It also covers creating and maintaining files and fields, setting up cross-references and keys, auditing, security, and archiving capabilities.
This document provides an overview of the major APIs in Fileman including classic calls, the database server API, Screenman forms, and developer tools. It discusses functions like ^DIC, ^DIE, and ^DIK for data access and editing. It also covers Screenman for building forms, the database server calls for communication, and tools for importing/exporting and internationalization.
The Amazing Charts EHR system allows medical practices with 10 or fewer clinicians to completely document patient encounters. It includes features like charting, e-prescribing, scheduling, billing integration, and decision support tools. The software costs $2,395 per clinician for a license, and $1,195 annually for maintenance and support. Additional optional services like cloud hosting, offsite backups, and billing services are also available for monthly or annual fees.
This document discusses clinical quality measures (CQMs) that eligible providers must report on in 2014. It begins with an introduction to the speaker, Kintu Shah. It then provides details on the 9 CQMs that must be reported on for adult patients and the 9 for pediatric patients, including which domains they fall under. The document reviews resources for CQMs and provides tips for working with CQMs, such as understanding measure components and using appropriate encounter codes. It also discusses capturing information across visits and providers, issues with cancer staging, and improvements to the EHR system for supporting CQMs.
Why should a health plan invest in integrated solutions when providers have more to gain? How to remove the risks of moving forward without an industry standard? Safe harbor investment? Is an all-payer/all-provider solution even possible today? How do I justify an investment in workflow automation and backend system integration? This is a webinar on extension of the successful conversation on claims attachments raised at WEDI National 2016. Three healthcare vendors came together to discuss how to overcome key challenges by leveraging current investments in a multi-vendor model.
EON Systems' The Digital Office Version 5.0 electronic health record software received certification from ONC-ATCB as a Complete Ambulatory EHR. The software supports chiropractic, physical therapy, and multi-disciplinary practices. It received certification according to criteria adopted by the Secretary of Health and Human Services, supporting Stage 1 meaningful use measures to qualify providers for funding under the Recovery Act. The software certification number is IG-2658-11-0137 and was certified on October 25, 2011.
The document describes Cloudpital, an electronic medical record (EMR) software. It provides information on Cloudpital's features such as maintaining patient documentation, managing medication and problem lists, capturing clinical documents, and creating care plans. Cloudpital allows for flexible workflows and customizable templates. It also discusses Cloudpital's global offices, how it works in hospitals, advantages for users, and analytics capabilities. The document promotes Cloudpital as providing the best EMR solution.
This document provides an overview of Entrada, a healthcare technology platform designed to help medical facilities streamline clinical documentation workflows. It describes Entrada's core functions like automatically routing clinical information between scheduling, medical records, and other systems. The document also outlines Entrada's models for ambulatory and acute care, explaining how it generates work lists, routes dictations for processing, and returns completed documentation to electronic health records.
CHI Memorial's 2015 Year in Review document provides an overview of the hospital's accomplishments in 2015 and plans for 2016. Key highlights from 2015 include an increase in admissions and ER visits, improvements in quality metrics like patient safety and experience, expansion of cancer services, and 100th TAVR procedure. Plans for 2016 focus on infrastructure projects, expanding services, and technology transformations like upgrading communication systems and pursuing meaningful use of electronic health records.
This document provides an overview of Health Catalyst, a company that provides healthcare data warehousing and analytics solutions. It discusses Health Catalyst's mission to transform US healthcare using data-driven insights. The company offers an enterprise data warehouse, data integration tools, reports/dashboards, and applications for quality improvement, population health and predictive analytics. Case studies demonstrate successes in cost savings, core measure performance, and clinical outcomes.
mHealth Israel_Ben Echeazu_Highmark Health_ Startups Engaging with US PayersLevi Shapiro
Presentation by Ben Echeaz, Business Development Director, Highmark Health, March 25, 2019, for the mHealth Israel community: Startups Engaging with US Payers. Includes overview of the US Payerand health insurance sector, Relationship to Blue Cross Blue Shield, Challenges in addressing needs and gaps through Big Data technology, How Payers de-risk their reimbursement and coverage decisions with early stage startups, the role of Big Data in informing the movement toward value-based healthcare, Enterprise focus areas across 7 major applications: Diagnostic, Preventative, Precision Medicine, Adverse medication events, Cost reduction, Medical research Population health, etc. Highmark's VITAL has projects in the top 5 areas, these area are not mutually exclusive.
Value Based Care Model
Inadequate Evidence
Solution
Traversing “Valley of Death”
De-risking Reimbursement
Vital Innovation
Conclusion
Focus areas for evidence development
- Chart My Meds is a cloud-based secure medication list that is HIPAA-compliant and does not store PHI on servers. It has a low learning curve for both patients and providers.
- The medication list can be integrated with EHR systems to provide a consistent discharge medication list for improved care coordination across providers.
- The platform allows for dynamic paper and digital medication lists that can be easily shared and updated among all providers to aid medication reconciliation.
Enterprise systems in healthcare: leveraging what we know from other industr...CONFENIS 2012
Dr. Carol Brown - distinguished professor at Stevens Institute of Technology , The Howe School of Technology Management
enterprise systems in healthcare: leveraging what we know from other industries
Harness Your Clinical and Financial Data with an Enterprise Health Informat...Perficient, Inc.
The importance of Enterprise Health Information Exchange (EHIE) as a key way to empower your physicians and patients and demonstrate meaningful use of electronic health records:
- Present the business case for EHIE as an important architecture that matters to progressive health systems
- Take a look at some of the market-leading EHIE architectures and products
- Provide real exam...ples of organizations that are using EHIE to improve their operations
HySynth Clinical Data Repository is used for storing, integrating ,managing and reporting on clinical studies.
It enables pooling of clinical and nonclinical data from multiple sources into a single environment. Better regulatory compliance with comprehensive security, an audit trail, and traceability, More-informed decision-making through pooling and analysis of clinical and nonclinical data
CDR has been developed to revolutionize ability to:
- Address complex health authority questions quickly and completely
- Produce CDISC compliant submissions
- Review safety data in real-time, mine our overall database for scientific and commercial queries
At HySynth provide,
- Business case development and cost analysis
- Requirements and design management
- Best practice analysis and recommendations
- Installation and configuration
- Oracle CDA and LSH pilots and proofs of concept
- Hosting
- Oracle CDA and LSH implementation
- CDA and LSH validation
- CDA and LSH training
- CDA and LSH extension development
LST on the following applications
- Argus Safety Suite
- Oracle Clinical / Remote Data Capture (RDC) /
- Thesaurus Management System (TMS)
- Oracle Inform EDC / Central Designer / Central Coding
- Life Sciences Data Hub (LSH)
- Oracle Data Management Workbench (DMW)
- Oracle Clinical Development Analytics (CDA)
- Adverse Event Reporting System (AERS)
- SAS
PILSrx, from Procurement to Patient, how the Australian Defence Force maximis...Ocean Software
PILSrx is the Pharmaceutical Integrated Logistics software that is used by Australia's Defence Forces to manage the supply chain of all the pharmaceuticals procured by the ADF and distributed to personnel.
This presentation was recently delivered at the MILCIS 2017 conference by Ocean Software MD, Mr Bruce Moors.
I-Seha, National Health Information System, BahrainUNDP India
The Ministry of Health in Bahrain implemented a National Health Information System called I-Seha with Indra Company to improve healthcare services. I-Seha creates a paperless system that integrates clinical and administrative solutions across primary care, secondary care, and hospitals. Patient information is compiled into a single Electronic Health Record accessible anywhere. The goals of I-Seha are to enable quick health data sharing between professionals, unlimited access to health records across facilities, integrated medical services, availability of data for informed decisions, and improved quality of care through technology.
The document discusses several healthcare technology companies that provide solutions for exchanging clinical data and orders between healthcare providers. This includes aggregating and normalizing scattered clinical data from labs and diagnostic imaging to improve care coordination and population health management. The companies described offer electronic health record integration, a clinical data exchange hub, and tools to match individual patient or member data to facilitate care management.
The document discusses advanced tools and techniques in FileMan such as import/export of data between applications, relational navigation between files, computed expressions, use of FileMan functions, and system management features like standalone FileMan and alternate editors. It also covers creating and maintaining files and fields, setting up cross-references and keys, auditing, security, and archiving capabilities.
This document provides an overview of the major APIs in Fileman including classic calls, the database server API, Screenman forms, and developer tools. It discusses functions like ^DIC, ^DIE, and ^DIK for data access and editing. It also covers Screenman for building forms, the database server calls for communication, and tools for importing/exporting and internationalization.
This document provides an overview of Paladin Medical Products, LLC, which designs and manufactures equipment management systems for clinical environments. Some key points:
- Paladin has decades of experience in clinical equipment interface design and problem solving.
- Their rail-based systems are designed to provide flexibility and control for clinicians over the layout and attachment of devices in patient rooms.
- Integration of equipment rails can help facilities achieve process improvement goals by ensuring clinicians have the right tools in the right places at the right times.
- Paladin offers a wide variety of mounts, adapters, and accessories that can attach most any clinical device or piece of equipment to their rail systems, helping support infection control and allowing easy re
This document provides an overview and introduction to FileMan, the database management system used throughout most VistA applications. It discusses basic FileMan terminology like files, records, fields and different field types. It also covers how to display, enter and edit data using various FileMan features like inquiring, printing, searching, sorting, the screen editor and line editor.
Drug Information Services, Drug information Sources, Illegal DIC, Drug Information Bulletin, Classification of scientific literature, services offered bu drug information services
The document discusses drug information centers (DICs), which provide unbiased drug information to healthcare professionals. DICs were first established in the 1960s and are usually located in major hospitals and health facilities. They are staffed by pharmacists with specialized training who locate, evaluate, and communicate drug information to answer questions from other healthcare providers. DICs aim to promote evidence-based practice and rational drug use through services like answering drug-related queries, publishing bulletins, and educating students.
The first drug information center opened in 1962 at the University of Kentucky Medical Center. By 1973 there were 54 drug information centers in the United States. Drug information centers respond to inquiries about various drug-related topics like efficacy, interactions, dosage, and administration. The scope of their work focuses on ensuring the "five rights" of drug use - the right drug, dose, form, route and patient.
The document provides a history and overview of poison control centers and their organization and operations. It discusses how the first poison control centers were established in the 1930s-1980s and key roles of pharmacists. The goals of poison control centers are to provide comprehensive, accurate and timely information to clients and enhance medical care of patients. It outlines the typical personnel, resources, equipment, policies and procedures needed to organize and run an effective poison control center.
Drug information centers provide unbiased drug information to healthcare professionals and patients. The first drug information center was established in 1960 at the University of Kentucky. In Nepal, drug information centers are still in their infancy. The Drug Information Network of Nepal was established in 1996 with participation from government, academic, and non-government organizations to disseminate drug information. The network aims to optimize drug use and decision making in Nepal through sharing up-to-date, evaluated information on drugs.
The document provides an overview of principles of drug information and the systematic approach used to answer drug-related questions. It discusses key drug information references, both general references like CPS and specialized references covering interactions, adverse reactions, pregnancy/breastfeeding, and natural products. The systematic 10-step approach involves collecting requestor details, determining the question, finding and assessing relevant information from references, formulating a response, and following up.
The ACE @ 25 programme is a clinical balanced scorecard used by Apollo Hospitals that incorporates 25 clinical quality parameters across major specialties. It benchmarks outcomes against top international hospitals and provides weighted scores on outcomes. The programme aims to improve clinical excellence across Apollo Hospitals by measuring and monitoring key quality indicators. It provides a centralized online platform for 33 Apollo Hospitals to enter, track, and improve their performance on core clinical metrics.
Running Head BELLEVUE HOSPITAL AND THE HEART HEALTH SERVICES .docxhealdkathaleen
Running Head: BELLEVUE HOSPITAL AND THE HEART HEALTH SERVICES 1
BELLEVUE HOSPITAL AND THE HEART HEALTH SERVICES 2
Bellevue Hospital And The Heart Health Services
Introduction of Bellevue hospital and the heart health service
Bellevue Hospital is the oldest public hospital in the USA and boasts having the most effective staff in line with the goals of the hospital in caregiving. Located at 462 First Avenue in the Kip bay of Manhattan in New York City. Currently, it serves an average of 460000 outpatients and has grown to be one of the most efficient hospitals in New York City. The heart health service is housed in the cardiology, and cardiothoracic surgery department which is world-renowned and the heart health program is among the few departments in the world and has a state of the art labs and have “our door to STEMI” produces better services beyond the average (Root, Schonfeld, Williams, & Poppers, 2017).
Mission, vision and strategic goal of the organisation
The mission of the hospital is to provide the highest quality of care to all the needy people in New York and all over the world with honesty, integrity, and with dignity even if the patient is not in a position to pay for the service that has been provided to them. The vision of the hospital is to be among the top ten hospitals in the country as far as the provision of quality service is concerned. Further, the hospital has a strategic goal of making the hospital the most popular in terms of compliance and service delivery so that all the people would work better at all time without any failure (Bellevue, 2016). Another strategic goal is improving communication so that the service delivery can be first, efficient and up to date.
The current state of the service using the marketing framework
The current state of the service is that it has invested in technology to serve the goals and ambitions of the hospital. It has incorporated technology to come up with the state of the art lab where people all over the country can be served. It is one of the hospitals where open-heart surgery is performed. Since the need of the hospital is to be the go-to place, it has ensured that the appropriate technology, leadership, and correct values to ensure that the correct virtues of the hospitals are maintained for better service delivery.
Stakeholders of the organization using the marketing framework
The Bellevue hospital has several stakeholders who interact in a very effective way to maintain the business in the hospital. The first stakeholders are the patients who pay for the services and the physicians who work around the clock to ensure that the patients always get what they pay for. The government is yet another stakeholder mainly mandated to monitor and ensure that the organization operates within the dictates of the law. Insurance companies and pharmaceutical companies all work together to ensure that the goals of the o ...
The document discusses regional extension centers (RECs), electronic health records (EHRs), and meaningful use. It notes that RECs were established to help healthcare providers adopt EHRs and achieve meaningful use through technical assistance. RECs work to enroll over 100,000 priority primary care providers by 2012. The document also provides an overview of meaningful use criteria and incentives for Medicare and Medicaid providers that successfully adopt and utilize EHRs.
NextGen Healthcare is an electronic health record (EHR) vendor that offers an integrated EHR and practice management solution from a single database on a single server. The document discusses 6 secrets or criteria for selecting an EHR vendor, including choosing an integrated rather than interfaced solution, partnering with a stable and established company, selecting a customizable certified solution tailored for specialty needs, ensuring resources to meet meaningful use goals, finding a comprehensive long term partner, and choosing a partner involved in industry standards and the evolution of healthcare IT.
Oracle provides comprehensive, end-to-end healthcare solutions to help improve patient care and outcomes while maximizing efficiency and containing costs. Their solutions include electronic health records, population health management, care coordination, and analytics capabilities. Oracle aims to help healthcare organizations improve operational efficiencies, enhance security and data sharing, and make more informed financial decisions through integrated platforms and applications.
The document discusses NextGen's pediatric EHR product. It addresses concerns about finding an EHR system suited for pediatric care and outlines NextGen's pediatric-specific features including growth charts, immunization tracking, and developmental templates. It also notes the product is certified for Meaningful Use stages 1 and 2 and is ready for ICD-10.
Ram Raju presented on NYC Health and Hospital's efforts to achieve "Healthcare Nirvana" through building robust integrated IT platforms. Key points include:
1) NYC Health and Hospitals is implementing an $800 million overhaul of its EMR systems by replacing multiple legacy systems with a single Epic system, integrating clinical and financial data.
2) Once complete, Epic will provide clinicians access to complete patient information across facilities to improve care coordination.
3) Additional integrated systems like Cerner for labs and Soarian for scheduling will further improve the patient experience and care delivery.
4) The integrated platforms aim to achieve the "Triple Aim" of improving patient experience and population health while reducing costs, through
This summary provides an overview of a proposed clinical database project for cleft patients in the East of England region:
The project aims to develop a collaborative web-based clinical database from an existing in-house database to standardize clinical data coding and provide an audit trail for cleft patients over a 20-year care pathway. The database will utilize SNOMED CT terminology and allow clinicians to track patient diagnoses, assessments, and outcomes over time to improve treatment. The database will require PHP, mySQL, and Apache resources and follow a MVC framework to separate the data, interface, and control layers to facilitate maintenance. The database aligns with UK clinical guidelines and aims to collect standardized data on approximately 1620 active cleft
Chapter 17 Implementing and Upgrading an Information System Soluti.docxcravennichole326
Chapter 17 Implementing and Upgrading an Information System
Solution
Christine D. Meyer
No matter whether the electronic health record (EHR) is new or an upgrade, the ultimate goal in implementations is to provide the highest level of care at the lowest cost with the least risk.
Objectives
At the completion of this chapter the reader will be prepared to:
1.Discuss the regulatory and nonregulatory reasons for implementing or upgrading an electronic information system
2.Compare the advantages and disadvantages of the “best of breed” and integrated system approaches in selecting healthcare information system architecture
3.Explain each step in developing an implementation plan for a healthcare information system
4.Develop strategies for the successful management of each step in the implementation of a healthcare information system
5.Analyze the benefits of an electronic information system with an integrated clinical decision support system
6.Explain the implications of unintended consequences or e-iatrogenesis as it relates to implementing an electronic health record (EHR)
Key Terms
Best of breed, 277
Big bang, 284
Phased go-live, 284
Scope creep, 276
Tall Man lettering, 276
Workarounds, 279
Abstract
The decision to implement a new electronic health record (EHR) or to upgrade a current system is based on several factors, including providing safe and up-to-date patient care, meeting federal mandates and Meaningful Use requirements, and leveraging advanced levels of clinical decision support. Implementing EHRs entails multilayered decisions at each stage of the implementation. Major decisions include evaluating vendor and system selection, determining go-live options, redesigning workflow, and developing procedures and policies. The timeline and scope of the project is primarily dictated by expenses, staff, resources, and the drop-dead date for go-live. Success depends on variables such as a well-thought-out and detailed project plan with regular review and updating of the critical milestones, unwavering support from the organization's leadership, input from users during the design and build phases, mitigation of identified risk factors, and control of scope creep. The implementation of an EHR is never finished. Medication orders, nonmedication orders, and documentation screens or fields will continuously need to be added, modified, or inactivated; patches will be installed and tweaks to workflows and functionality will be ongoing.
Introduction
This chapter focuses on the implementation of healthcare information systems. Of course, many different types of applications are used within a healthcare information system. The general principles for implementing these many different applications are the same; however, for the purposes of discussion this chapter will focus mainly on the implementation of an electronic health record (EHR) to demonstrate these general principles. In 2004 President George W. Bush promoted the i ...
1) The document describes an Insights as a Service platform that can help address multiple clinical, scientific, and economic needs by providing analytics and insights derived from large amounts of individual health data.
2) The platform establishes a standardized, industrialized process for generating insights through analytics by integrating data from various sources and providing role-based analytic tools and results.
3) Use cases for the platform include transitioning from volume-based to value-based healthcare through risk prediction and cost/utilization analytics, generating real-world evidence through large-scale analytics of electronic health data, and powering condition-specific care and population health management solutions.
M-health for cost savings and care managementAndy Arends
This document summarizes a presentation about using mobile health (m-health) technologies for cost savings and care management. It discusses what m-health refers to, common goals in using m-health like reducing readmissions and engaging members, barriers to m-health usage like cost and technology integration, and a case study on a telemonitoring program for congestive heart failure patients that led to reduced hospitalizations. The presentation concludes by discussing next steps in areas like remote monitoring, care coordination and wellness programs.
“Purchasing ‘HIS/HMIS integrated with EHR’ can
revolutionize your healthcare facility, Improve
revenue across Facility, and drive real results in
revenue, build brand and customer loyalty. But
how do you know where to start?”
Choosing a HIS/HMS solution is an important decision: not only
is it a significant investment in time and resources, the system
you choose will have an enormous impact on the daily activities
of both your clinical and non-clinical teams. So it’s important to
conduct the proper research and go into the process with the
right questions in hand.
The following three chapters will help you build a framework for
evaluating vendors, figure out questions to ask each, and find
your perfect solution — in three steps:
1. Self-Assessment
2. Goals & Planning
3. Vendor / Product Evaluation
Your company You are a new Supply Chain Analyst with the ACME.docxhyacinthshackley2629
Your company: You are a new Supply Chain Analyst with the ACME Corporation. We design specialty electronics that are components in larger finished goods such as major appliances, automobiles and industrial equipment. Manufacturing is outsourced to low-cost suppliers due to the significant labor contribution and closeness to electronic component suppliers.
Your product: ACME Corp. designs a leading-edge family of devices branded as “Voice Assistants.” These are add-on boxes that many OEMs are using as plug-and-play devices in a wide variety of Internet-of-Things products. They are also sold directly to consumers as after-market items, but only for IoT devices that were built with our proprietary data-port.
Figure 1: Product line of ACME Corp Voice Assistant IoT Add-on Boxes
Your task: Your Chief Supply Chain Officer (CSCO) is requesting a review of supplier-to-customer processes as related to recent growth in our company and increasing demand for faster responsiveness to customers. One alternative is to decentralize our inventory into regional Distribution Centers; however, our ERP system is currently limited in the data available to make some of these decisions – and the output reports are very antiquated. Starting off the process, the CSCO directed that your Analysis Team use population data to pro-rate our national sales data as a starting point. For this analysis, you are asked to focus only on the flagship product, Voice Assistant IoT Add-on Box, 4GB, SKU #123-456789. The challenge is now yours to complete some computations and interpret the results!
Your data: A detailed report from your ERP system along with secondary data from the U.S. Census Bureau (reference: https://www.census.gov/programs-surveys/popest/data/data-sets.html) is provided. (Note: Sales to Alaska, Hawaii and Puerto Rico are handled by a 3PL provider and therefore are NOT part of this analysis.) The consolidated EXCEL® file has incorporated several tasks already performed by the Analysis Team --- sort, cleanse, inventory optimization, etc. Other tasks remain for your team.
Detailed Requirements: Prepare a formal report summarizing your results and providing recommendations that are supported by facts. The required layout follows:
A. Supply Chain Management:
a. Identify a single key supplier and a single key customer for your product, including a brief description of their product.
b. Identify the proper type of business relationship that your company should have with the supplier and customer from Part A, above, then briefly describe the data that you would share with them.
c. When implementing Supply Chain Management with your #1 key supplier for the first time, create a timeline that lists each of the six SCOR processes in the order that you recommend implementation; include process leader (by job title), primary contact at supplier/customer (by job title), and duration to implement.
d. Briefly describe each of the four enablers of supply chain .
This is the first installment of the hitchhiker's guide to Health Level Seven. When complete this presentation will provide a concise overview of the history, operational framework, and standards of Health Level Seven (HL7). It is intended to be a guide to those seeking to engage in the HL7 standards development effort or to be consumers of HL7 products and services.
The presentation is being written and posted in five iterations. This particular installment introduces HL7 the organization and HL7 the portfolio of health informatics standard.
This document describes a patient informatics platform that aims to help physicians, patients, and users manage healthcare costs and improve health outcomes. The platform collects medical data to provide personalized alerts and feedback. It monitors health conditions like diabetes and heart disease. Benefits include wellness monitoring, reduced costs, and increased flexibility. The platform extracts medical records, shares care information electronically, and alerts doctors to deviations. It tracks treatment outcomes and compares to published data. The goal is encouraging preventative care and changing health habits to reduce visits and healthcare spending.
The document discusses how the HITECH Act and meaningful use requirements will impact the future of healthcare technology management by requiring hospitals and providers to adopt and meaningfully use electronic health records in order to receive incentive payments, which aims to improve quality, safety and efficiency and reduce costs through greater health information exchange and use of clinical decision support. It also outlines the stages of meaningful use and quality measures that must be met, as well as considerations for ensuring compliance and leveraging best practices to help transition systems and processes under the new health IT requirements.
WorldOne is an international research agency specializing in healthcare data collection with one of the largest healthcare panels in the industry. They answered ESOMAR's 26 questions to provide details on their panel recruitment process, data quality validation policies, and compliance with industry standards. Their healthcare panel consists of over 1.6 million medical professionals recruited through telephone and in-person verification to ensure high quality data.
ICD-10 Presentation to Bays Medical Society January 2014Florida Blue
Collaboration between physicians, payers and others across the health care industry is critical to a successful ICD10 implementation. Florida Blue is here with resources and expertise as you begin your ICD-10 journey, but the time to act is now! Visit our site to get started: http://ow.ly/sGVfF
Kathleen McCloskey has over 25 years of experience as a healthcare systems analyst, consultant, and project manager for electronic health record implementations. She has extensive experience leading projects for Allscripts Sunrise and Siemens applications, including configurations, testing, training, and optimizations. Some of her roles included developing training materials for case management and utilization review, leading radiology builds, and analyzing workflows to help organizations meet meaningful use criteria.
This document provides a summary of the Hospital Management Information System (HMIS) and implementation process at dwise Healthcare. It discusses the key modules in HMIS including outpatient, inpatient, billing, laboratory, radiology. It describes the features of outpatient registration and appointment management. The implementation process focuses on customizing the system to client workflows and standards, training staff, go-live support and maintenance support. The HMIS is implemented using a phased approach to ensure a smooth transition from paper to digital records.
Similar to OpenVista Electronic Health Record System Request for Information Response (20)
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
At Malayali Kerala Spa Ajman, we firmly believe that everyone should have the option to experience top-quality massage services regularly. To achieve that goal we offer cheap massage services in Ajman.
If you are interested in experiencing transformative massage treatment at Malayali Kerala Spa Ajman, you can use our Ajman Massage Center WhatsApp Number to schedule your next massage session.
Contact @ +971 529818279
Visit @ https://malayalikeralaspaajman.com/
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Data-Driven Dispensing- Rise of AI in Pharmacies.pdf
OpenVista Electronic Health Record System Request for Information Response
1. Final Project
Independent Masters Capstone
Winter Quarter, 2012
Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
2. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
2
INTRODUCTION
RJH Consulting is preparing a report devoted to a review and
comparative analysis of the OpenVistA1
electronic health records (EHR) 5
system
for your facility as per your request. This report will form the foundation for
recommendations to the OpenVistA1
EHR5
for Accountable Care Organizations2
(ACOs) that are interested in investing and implementing EHR5
technology. This
report will be based on information received from your RFI. In addition, the
comparative analysis of OpenVista1
EHR5
system will be supported by insight
from Meaningful Use3
metrics and the findings of interviews conducted with
stakeholders with your ACO2
.
PURPOSE
This Request for Information is proprietary to RJH Consulting. It is
drafted and disseminated for the sole purpose of generating information on
OpenVistA1
’s EHR5
system in order to promote the quality and connection to
help achieve Meaningful Use3
within your ACO2
.
GENERAL
BACKGROUND
Historically, EHR5
systems have been comprehensive end-to-end systems
with significant infrastructure, integration and training requirements. The latest
buzzwords in health IT are meaningful use and usability, where usability, in
particular, having initially been long overlooked is getting a lot of attention.
Most of them are architecturally complex to deploy and maintain, and rely on
proprietary software, systems and data models. However, without adequate
training and education, usability can be an issue.
3. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
3
Today, health services providers have multiple options to consider in how
they deploy an EHR5
system. The needs of small private practices are vastly
different from those of larger integrated health systems. Providers and policy
makers must consider alternative software and informatics models before
investing in systems. Planning is needed to implement an EHR5
in order to
ensure that it can continue to provide high-quality and high-value healthcare
services in an increasingly electronic and paperless world.
During this time, end users will have a slew of choices when it comes to
vendors. The non-profit Certification Commission for Health Information
Technology (CCHIT) 4
, points to over 100 certified products in its portfolio.
American National Standards Institute7
-accredited Health Level Seven (HL7)6
International is also developing a set of standards by which to evaluate EHR5
systems. This report will help your stakeholder’s jumpstart their EHR5
selection
process. In it, we'll share the results of the responses to your RFI, taking a look at
what EHR5
system and tools OpenVistA1
offers. We’ll examine features and
functions of OpenVistA1
and match them to the needs of your organization to
help align business processes with your missions and goals.
OpenVistA1
Background
The following requirements are necessary to illustrate OpenVistA1
’s
dedication to the success of your EHR5
implementation. We want to share with
you are credentials to demonstrate that we are the right choice for your
organization.
__X_ Vendor’s EHR is CCHIT4
certified
Physicians using CCHIT4
Certified EHRs5
will enhance the quality and
safety of their care and decrease their medical legal risk. Furthermore, CCHIT4
Certified Products tie directly to Health IT Meaningful Use payments, called for
4. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
4
under the American Recovery and Reinvestment Act (ARRA) 8
, whereby
facilities will be eligible to receive payments from the Centers for Medicare and
Medicaid Services (CMS) 9
for EHR5
Meaningful Use3
.
__X_ OpenVistA1
EHR caters to small to midsize medical practices
Due to the flexibility of OpenVistA1
EHR5
system, we can accommodate
small-sized ACO2
s, single or solo-run medical practice to a group of 15
practitioners; mid-size group can be 15-50 practitioners and larger groups over 50
practitioners.
__X_ OpenVistA1
will provide 2-3 references from past and current clients
We believe that references can provide an excellent way for potential
clients to see the value in our products and services by listening to the testimony
of our previous clients. This way they will find commonalities in problems and
solutions which will emphasis our commitment to quality. References available
upon request.
BUSINESS
OVERVIEW
Midland Memorial Hospital10
is a 371-bed community hospital that
operates three campuses in Midland, Texas. Midland Memorial10
provides a full
range of acute-care services including emergency medicine, cardiovascular
surgery, and advanced radiological and oncology services and serves as a regional
referral center for other communities throughout west Texas and southeast New
Mexico. The Midland Mmeorial10
“OpenVistA1
Implementation Project”
represents a formidable challenge on multiple fronts.
For example, it is the first nongovernmental, acute-care hospital in the
United States to adopt an OpenVistA1
-based EHR5
; it has a community-based
physician staff representing all major specialty areas; and they want a “best of
5. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
5
breed” software environment that leverages investments in current solutions that
needed to be interfaced to OpenVistA1
. The contract for the project is awarded to
Medsphere Systems15
Corporation.
BUSINESS
OBJECTIVES
Since wellness and patient-centered care is at the core of this particular
medical practice, practitioners and staff eagerly wants to adapt an EHR5
that has
standard core features in addition to including extra components to enhance
quality, disease management and population care management. To that end, the
Midland Memorial’s10
staff hopes to continue providing quality service by way of
excellent patient satisfaction scores and improved Healthcare Effectiveness Data
and Information Set (HEDIS)11
results in the coming years. The selected EHR5
technology will assist the practice in achieving this goal.
GUIDING
PRINCIPLES AND
MAJOR PROJECT
OBJECTIVES
• Enhance patient safety, increase clinical efficiency/ improve healthcare quality.
• Standardize the delivery of care across the continuum (acute, ambulatory, and
rehabilitation) and multiple geography locations of care (hospitals and clinics).
• Reduce medical errors and wasteful costs associated with the delivery of health
care.
• Build upon the proven success and experience of the VA in the implementation
of its comprehensive OpenVistA1
EHR5
for Midland Memorial10
.
• Leverage the OpenVistA1
EHR5
as a differentiating factor in helping recruit and
retain patients, physicians and staff.
• Leverage the OpenVistA1
to reduce Midland Memorial10
overall systems
lifecycle costs.
6. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
6
PROJECT
HISTORY
Midland Memorial Hospital10
has determined to replace their “sun
setting” pharmacy and laboratory systems. This review prompted IT steering
committee members to rethink their best-of-breed strategy and take the
opportunity to evaluate a single, integrated solution to meet their clinical,
administrative, and financial needs. During the course of their evaluation of
traditional healthcare IT companies, they were unable to overcome the $20
million price barrier to implement the comprehensive solution they envisioned.
They became aware of OpenVistA1
through their interaction with the Big Springs
VA Medical Center12
and the realization that there were multiple commercial
vendors supporting the OpenVistA1
solution.
Midland Memorial10
next engaged in a rigorous 12-month evaluation of
the technology, product and Health IT service providers. After attending several
national conferences, completing multiple site visits, and a series of intense
product demonstrations to its staff, Midland Memorial10
decides to move forward
with a comprehensive enterprise assessment of the issues related to implementing
the OpenVistA1
solution. After the completion of the assessment, Midland
Memorial’s10
IT steering committee unanimously approves the recommendation
to begin the OpenVistA1
project.
With OpenVistA1
serving as the platform of innovation, a six-month
software development effort ensues to ensure that the product will meet some of
the unique functional specifications of Midland Memorial10
. A primary objective
of this effort is to complete the required interfaces to share patient demographic
information, the event points where charges can be captured, and the seamless
7. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
7
sharing of information among 13 disparate information systems Midland
Memorial10
wants to retain. This process is successfully completed by a talented
team of OpenVistA1
engineers who had a thorough knowledge of the system and
leveraged standard VA design concepts, improved existing software tools, and
developed new integration utilities to accomplish the work. These efforts prove
highly successful and set the stage for the next step, the clinical configuration of
the system.
Clinical configuration of the system begins with the training of six newly
hired registered nurses who form the core of Midland Memorial’s10
clinical
information technology (IT) team. These individuals, under the direction of a
Midland nurse informaticist, are training to become “super users” of the graphical
user interface to OpenVistA1
, known as the Computerized Patient Record System
(CPRS) 13
. This training gives them the knowledge needed to create templates,
order sets and clinical reminders; set clinical rules; and configure other
OpenVistA1
clinical modules. Staff from Medsphere15
augments their staff
during the design, configuration, training and deployment of the OpenVistA1
system. The goal of the training program is designed to allow Midland
Memorial10
to become a self-sufficient organization that would not be dependent
on a vendor for many of the ongoing operational and maintenance tasks.
Multiple committees convene, under the direction of the IT steering
committee, to ensure a smooth transition to the OpenVistA1
EHR5
. These multi-
disciplinary subcommittees include Computerized Provider Order Entry, Bar
Code Medication Administration, Forms, Pharmacy, Medical Records and
Ancillary Department committees. The various subcommittees report up to the
IT steering committee, which meets monthly for the duration of the project.
8. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
8
Midland Memorial10
and Medsphere15
also establish a joint project governance
structure with regular project communication and issue resolution meetings.
SYSTEM
ARCHITECTURE
The enterprise architecture chosen by Midland Memorial10
includes a
centralized server cluster with a single OpenVistA1
database residing at Midland
Memorial’s10
main campus facility. Midland Memorial10
selects InterSystems
Cache product for its “M” language and database environment due to its robust
capabilities, proven scalability and rich management tool set, which had been
deployed in large-scale clinical settings. The multi-campus enterprise is the first
acute-care hospital to deploy the OpenVistA1
EHR5
solution on a Red Hat
Linux16
infrastructure. A high-availability cluster, using multi-processor x86
servers and clustering software, is installed and configured by Hewlett-Packard
(HP) 14
. This technology configuration provided Midland Memorial10
with an
affordable, high-performance, and completely redundant solution using a mix of
open source tools, proven application servers, and commodity x86-based
hardware.
9. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
9
SOFTWARE
SOLUTION
Midland Memorial’s10
best-of-breed software environment presents some
challenges for a fully integrated solution like OpenVistA1
. Medsphere15
is
required to develop several enhancements and interfaces to present a unified
solution within the VistA framework. Midland Memorial10
currently uses
McKesson’s Precision 2000 Health Information System. Precision serves as the
authoritative source of patient demographics, registration, scheduling, master
patient index, and other master files. It is also the primary source of order entry
by the ward clerks for laboratory, cardiopulmonary, dietetics and related consults.
Once patients register, the information is sent to OpenVistA1
by standardized
HL76
messages where it is then “filed” away in the appropriate places within
OpenVistA1
.
From here, at key steps of the clinical-care process, various “events”
trigger the charge capture engine to fire off a charge-related message to the
Precision system. After the clinical course of care has ended, the Precision
system generates a bill and manages the revenue cycle from that point forward.
Medsphere15
developed a unique technology solution to assist with both the filing
and the charge capture component of this interface. The primary OpenVistA1
modules initially to be deployed at Midland Memorial10
included the following:
• FileMan • Radiology and Nuclear Medicine
• Kernel • Computerized Patient Record Sys
• MailMan • Adverse Reaction Tracking
• Patient Information Management • Authorization/Subscription Utility
• Master Patient Index (MPI) • Clinical Reminders
• Inpatient Pharmacy • Consult/Request Tracking
• National Drug File • Health Summary
• Outpatient Pharmacy • Problem List
• Laboratory
10. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
10
Medsphere15
OpenVistA1
Enhancements Developed for Midland Memorial
The above packages provided the foundation of the OpenVistA1
solution.
From here, Medsphere15
was required to make the following modifications. This
list is not comprehensive, but is representative of the types of changes required to
adapt OpenVistA1
technology in a non-VA setting.
GENERAL:
• Fee Tables in OpenVista1
linked to a foreign system’s Charge Master File
• Common Physician Identifier
• Protocol Event Points for charge capture with HL76
interfaces
• Options to populate User (NEW PERSON) file from a foreign registry
PATIENT REGISTRATION:
• Creation of a common Medical Record Number
• Creation of Account Number file and corresponding field in Visit file
• HL76
interface from authoritative medical manager to OpenVistA1
PHARMACY:
• Charge capture for real-time or batch transmission to foreign billing system
• High Dose Alerts
• Pharmacokinetic Dosing
• Link Lab Results to Inpatient Med Order
LABORATORY:
• Charge capture for real-time or batch transmission to foreign billing system
• HL76
interface for intake of lab orders
• HL76
interface for reporting out of lab orders
• Tracking Specimen Transfers between Facilities
• Faxing of Laboratory Results
• Creating multiple interfaces for Blood Bank
RADIOLOGY:
• HL76
interface for intake of radiology orders
• HL76
interface for reporting out of radiology orders
• HL76
interface for intake of radiology result reports
• Charge Master file automatically populates/ updates Radiology procedure
file
IMAGING:
• Developed document scanning enhancement
11. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
11
PROJECT
CHALLENGES
• Clinical business transformation and Health IT systems implementation.
• Hardware and Infrastructure Enhancements:
• Upgrade network infrastructure to accommodate user’s needs.
• Upgrade existing hardware for improved reliability and performance.
• Upgrading clinician work spaces to increase access and ergonomics.
• Interface challenges integrating over 15 disparate information systems.
• Mission-critical application training 1,500 users for 24/7organization.
• Project management challenges of moderating expectations, managing
personnel, and developing a repeatable deployment methodology with no
commercial precedent.
• Developing an internal support function aligning to organization and the end
users needs; integrating customer and vendor application support.
The following describes OpenVistA1
’s ability to match Meaningful Use3
Stage 1
• Computerized physician order entry (CPOE);
Orders for lab orders, procedures, diagnostic studies, immunizations and
referrals can be entered electronically and tracked throughout their lifecycle
to a completed or resulted status. Medication prescriptions can be entered
electronically, and OpenVistA1
EHR5
supports e-prescribing to pharmacies.
• Recording patient demographics;
Patient demographics can be recorded using OpenVistA1
EHR’s5
• Maintaining a problem list of diagnoses;
OpenVistA1
EHR5
supports comprehensive problem lists using ICD917
codes
with problems separated into Active and Inactive Problems. Status and
severity can be tracked along with onset, diagnosed and resolved dates.
• Prescribing electronically (e-prescribing);
OpenVistA1
EHR’s5
allows providers to easily perform e-prescribing to
community pharmacies and mail order pharmacies.
• Maintaining an active medication list for patients;
The OpenVistA1
EHR5
maintains complete patient medication lists using
NDC codes and includes active, inactive and temporary prescriptions.
12. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
12
• Implementing drug/allergy checks at the point-of-care;
OpenVistA1
EHR5
supports automatic drug-to-drug and drug-to-allergy
interactions as well as contraindication alerts and duplicates medication
checking.
• Preventive medicine and health education;
OpenVistA1
EHR’s5
health maintenance templates display the status of
preventative care for patients, and feature standard-based alerts based on
guidelines from the AAFP18
and USPSTF19
. At a glance, providers can be
prompted to order overdue exams, tests and procedures.
• Sending patient alerts and reminders;
OpenVistA1
EHR5
supports custom reminder letters that can be generated on
an individual basis. OpenVistA1
EHR5
Report Writer can run custom reports
to identify patients that are due for care and the data can be exported to Excel
for mail merge.
• Sharing patient records among providers;
Multiple-location practices can instantly access and document inpatient
records from any location. This provides patients with the flexibility to make
appointments or receive test or lab results at any location without causing a
paper chase for the practice.
• Providing patients with electronic copies of their medical records;
The OpenVistA1®
Patient Portal is an optional online gateway to the system
that allows patients to review documents online that include medical records,
lab results, etc. OpenVistA1
EHR5
Medical Summary Utility provides
several different methods of extending the patient chart including the export
and import of CCR20
and CCD21
.
• Support for and/or integration with systems for verifying insurance
eligibility and submitting claims electronically; and,
Integrated into OpenVistA1
EPM workflow, OpenVistA1
RTS allows
practices to electronically perform eligibility checking via HIPAA22
-
compliant ANSI7
x12 270/271 Eligibility Inquiry and Response files.
OpenVistA1
EPM can submit claims to any clearinghouse using the ANSI7
x12 data standard or submit directly to multiple payers that accept the ANSI7
x12 data standard.
• Data sharing with immunization registries and public health
agencies.
HL76 immunization export interface can be supported.
13. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
13
Meaningful Use Stage 1
Health Outcomes
Policy Priority Care Goals Objectives Measures
Improving quality,
safety, efficiency,
and reducing
health disparities
Provide access to
Comprehensive patient
health data for patient's
health care team
Use CPOE CPOE is used for at least
80% of all orders 23
Use evidence-based order
sets and CPOE
Implement drug-drug, drug-
allergy, drug- formulary
checks
The EPl has enabled this
functionality23
Apply clinical decision
support at the point of care
Maintain an up-to-date
problem list of current and
active diagnoses based on
ICD-917-
CM or SNOMED
CT ®
At least 80% of all unique
patients seen by the EP have
at least one entry or an
indication of none recorded
as structured data23
Generate lists of patients
who need care and use
them to reach out to
patients
Generate and transmit
Permissible prescriptions
electronically (eRx)
At least 75% of all
Permissible prescriptions
written by the EP are
Transmitted electronically
using certified EHR5
technology23
Report information for
quality improvement and
public reporting
Maintain active medication
list
At least 80% of all unique
patients seen by the EP have
at least one entry (or an
indication of “none” if the
patient is not currently
prescribed any medication)
recorded as structured data23
Maintain active medication
allergy list
At least 80% of all unique
patients seen, by the EP, have
at least one entry or
(indication of “none” if the
patient has no medication
allergies) recorded as
structured data23
14. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
14
Record demographics
o preferred language
o insurance type
o gender
o race
o ethnicity
o date of birth
At least 80% of all unique
patients seen by the EP
have demographics
recorded as structured data23
Health Outcomes
Policy Priority Care Goals Objectives Measures
Record and chart changes
in vital signs:
o height
o weight
o blood pressure
o Calculate and display:
BMI
o Plot and display growth
charts for children 2-20
years, including BMI.
For at least 80% of all
unique patients age 2 and
over seen by the EP record
blood pressure and BMI;
additionally plot growth
chart for children age 2-2023
Record smoking status for
patients 13 years old or
older
At least 80% of all unique
patients 13 years old or
older seen by the EP have
smoking status recorded23
Incorporate clinical lab test
results into EHR as
structured data
At least 50% of all clinical
lab tests ordered whose
results are in a positive/
negative or numerical format
are incorporated in certified
EHR5
technology as
structured data23
Generate lists of patients
by specific conditions to
use for quality
improvement, reduction of
disparities, and outreach
Generate at least one
report listing patients of the
EP with a specific condition23
Report ambulatory quality
measures to CMS9
or the
States
For 2011, provide
aggregate numerator
and denominator through
attestation as discussed in
section II(A)(3) of this
15. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
15
proposed rule; For 2012,
electronically submit the
measures as discussed in
section II(A)(3) of this
proposed rule23
Health Outcomes
Policy Priority Care Goals Objectives Measures
Send reminders to
patients per patient
preference for preventive/
follow up care
Reminder sent to at least
50% of all unique patients
seen by the EP that are
age 50 or over23
Implement 5 clinical
decision support rules
relevant to specialty or
high clinical priority,
including diagnostic test
ordering, along with the
ability to track compliance
with those rules
Implement 5 clinical
decision support rules
relevant to the clinical
quality metrics the EP is
responsible for as
described further in section
II (A) (3). 23
Check insurance eligibility
electronically from public
and private payers
Insurance eligibility checked
electronically for at least
80% of all unique patients
seen by the EP23
Submit claims electronically
to public and private payers.
At least 80% of all claims
filed electronically by the
EP23
Engage patients
and families in
their health care
Provide patients and
families with timely
access to data,
knowledge, and tools to
make informed
decisions and to
manage their health
Provide patients with an
electronic copy of their
health information
(including diagnostic test
results, problem list,
medication lists, allergies),
upon request
At least 80% of all patients
who request an electronic
copy of their health
information are provided it
within 48 hours23
Provide patients with
timely electronic access to
their health information
(including lab results,
problem list, medication
lists, allergies) within 96
hours of the information
being available to the EP
At least 10% of all unique
patients seen by the EP
are provided timely
electronic access to their
health information23
16. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
16
Provide clinical patient
summaries for each office
visit
Clinical summaries are
provided for at least 80% of
all office visits23
Health Outcomes
Policy Priority Care Goals Objectives Measures
Improve care
coordination
Exchange meaningful
clinical information
among professional
health care team
Capability to exchange
key clinical information
(for example, problem list,
medication list, allergies,
diagnostic test results),
among providers of care
and patient authorized
entities electronically
Performed at least one test
of certified EHR5
technology's capacity to
Electronically exchange
key clinical information23
Perform medication
reconciliation at
relevant encounters
and each transition of
care
Perform medication
reconciliation for at
least 80% of relevant
encounters and
transitions of care23
Provide summary care
record for each transition
of care and referral
Provide summary of care
record for at least 80% of
transitions of care and
referrals23
Improve population
and public health
Communicate with
public health agencies
Capability to submit
electronic data to
immunization registries
where submissions were
required and accepted
Performed at least one test
of certified EHR5
technology's capacity to
submit electronic data to
Immunization registries23
Capability to provide
electronic syndromic
surveillance data to public
health agencies and
actual transmission
according to applicable
law and practice
Performed at least one test
of certified EHR5
technology's capacity to
provide electronic
syndromic surveillance
data to public health
agencies (unless the public
health agencies to which an
EP submits do not have
capacity to receive info
electronically) 23
17. Independent Masters Capstone Roy Hoppe
OpenVistA1
Electronic Health Record System
Request for Information Response
17
Ensure adequate
privacy and
security protections
for personal health
information
Ensure privacy and security
protections for confidential
information through
operating policies,
procedures, technologies
and law compliance.
Provide transparency of
data sharing to patient.
Protect electronic health
information created or
maintained by certified
EHR5
technology through
appropriate technical
implementation.
Conduct or review a
security risk analysis per 45
CFR 164.308 (a)(1) and
implement security updates
as necessary23
References
1. OpenVistA http://sourceforge.net/projects/openvista/
2. Accountable Care Organizations https://www.cms.gov/ACO/
3. Meaningful Use http://healthit.hhs.gov/portal/server.pt?open=512&objID=1325&mode=2
4. Certification Commission for Health Information Technology http://www.cchit.org/
5. Electronic Health Records http://www.himss.org/ASP/topics_ehr.asp
6. Health Level Seven http://www.hl7.org/
7. American National Standards Institute http://www.ansi.org/
8. American Recovery and Reinvestment Act http://www.recovery.gov/About/Pages/The_Act.aspx
9. Centers for Medicare and Medicaid Services http://www.cms.gov
10. Midland Memorial Hospital http://www.midland-memorial.com/
11. Healthcare Effectiveness Data and Information Set (HEDIS)
http://www.ncqa.org/tabid/187/default.aspx
12. Big Springs VA Medical Center www.bigspring.va.gov/
13. Computerized Patient Record System cprs
www.va.gov/vdl/documents/clinical/...patient...(cprs)/cprssetup.pdf
14. Hewlett Packard http:// www.hp.com
15. Medsphere Systems http://www.medsphere.com
16. Red Hat Linux http://www.redhat.com
17. The International Classification of Diseases http://icd9cm.chrisendres.com/
18. American Academy of Family Physicians (AAFP) http://www.aafp.org/online/en/home.html
19. U.S. Preventive Services Task Force (USPSTF) http://www.ahrq.gov/clinic/uspstfix.htm
20. Continuity of Care Record (CCR) www.nchica.org/Past/06/presentations/Kibbe.pdf
21. Continuity of Care Document www.hitsp.org/ConstructSet_Details.aspx?&PrefixAlpha=4...32
22. The Health Insurance Portability and Accountability Act 0f 1996 http://www.hhs.gov/ocr/privacy/
23. Meaningful Use Standards https://www.cms.gov/.../Downloads/MU_Stage1_ReqSummary.pdf