This document discusses Grey Bruce Health Services' efforts to integrate clinical data across their region to improve patient care and provider efficiency. They established a connection to a third-party gateway to send lab results, reports, and other documents electronically from hospitals to physicians' offices. Over time they expanded to connect multiple clinics and vendors. This reduced paper, improved turnaround times, and allowed shared access to patient data across the integrated system. Future plans include expanding message types and connections to other organizations to further enhance regional data integration.
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Healthcare organizations facing migration to a new EHR will want to stop to consider these issues to ensure patient safety, satisfaction and clinical adoption.
Automation – Way Forward to Achieve Data Integrity
By Implementing Scientific Data Management System (SDMS), Electronic Lab Notebook (ELN) & Document Management System (DMS)
HospitalSoftwareShop provides exhaustive LIS Software - Laboratory Information System -for Pathology Labs. Being web-based makes lab software globally accessible. Software for labs offers widest range of pathology tests, direct integration with lab equipment without manual intervention reduces errors and time
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Slides for Akum Aveika 's talk on performing mobile data capture in the Tazama project. Presented at the London School of Hygiene & Tropical Medicine for a seminar on Mobile Data Collection seminar on Sept 27, 2013.
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Scientific & systematic collection of data for clinical study is called as Clinical data management .
EDC
RDC
HISTORY
EVOLUTION OF CLINICAL DATA CAPTURE
CRITERIA FOR IDENTIFYING AN EDC
REGULATORY GUIDELINE ON EDC
EDC ISSUES
VALIDATING ELECTRONIC SOURCE DATA
Preparation is the Key to Meaningful Use SuccessIatric Systems
To help hospitals and eligible providers navigate the changing landscape of Meaningful Use, we created an educational webcast.
This session provides valuable Meaningful Use information including:
• Recent updates from CMS
• Keys to audit preparation
• How to identify and correct gaps in your Meaningful Use plan
• How to ensure IMO data terminology mapping is completed accurately and on-time
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Healthcare IT has a last mile problem. Use of new clinical systems is being mandated, often at the expense of effectiveness and efficiency. The challenge is balancing the implementation of these new requirements with the need to optimize workflow for doctors and nurses. Learn how increasing the usability of clinical systems will result in increased productivity, improved clinician satisfaction, and improved patient care.
1. Data Integration in the
Community
Chrystelle Ayerhart
Interface Systems Analyst
Peggy Millar
Corporate Manager Computer Applications
Grey Bruce Health Services
2. Making DI/Lab Results and
Transcribed Documents Available
Electronically to
Community
Physicians
3. Grey Bruce Information Network
(GBIN)
• Approximately 9000 sq.
km (3,475 sq. miles)
• 3 corporations
• 11 hospital sites
• 1 outpatient clinic site
4. Strategic Goals (Technology)
• Grey Bruce Health Services will utilize
technology as it becomes available if it
improves efficiency and safety, and
enhances our service
• We will create mechanisms to share
information to support a seamless care
experience for the patient and to
improve system efficiency
5. Operational Goals
• Reduction of paper
• Enter data once, reduce the effort
• Reduce labour
• Sharable data
• User friendly applications
• Efficiencies
• Less steps for clinical staff
6. Provider Benefits
• Reduced turn-around time for results
• Faster diagnosis and treatment
• Results requiring follow up are flagged
• Time and labour savings – decreased manual
handling of result
• Decreased paper, decreased physician
storage required
• Vendor neutral
• Ease of connection
8. Previous Process
• Lab, DI and Medical Transcription
documents produced in hard copy
• Results are sorted, mailed or faxed to
physician offices
• Document handling:
– Must be printed
– Filed in the patient’s physical chart
– Possibly scanned into electronic format
9. Project Specific Objectives
• Improve the method of sending results
to local physician clinics
• Produce standard method of
communication
• Have a flexible, scalable solution –
recognized the need to send to multiple
locations
10. Design Approach
• Potential to apply technology to many
locations is apparent
• Opted for single interface working with
a 3rd party gateway
• Burden of processing and maintenance
occur at gateway
11. Design Approach Continued
• Standardized message structure makes
system vendor-neutral
• Gateway alerts of errored messages or
dropped connections
• Interface maintenance handled
completely in-house
12. Build Steps
• Resources
– Technical Coordinator
– Interface Systems Analyst
– Representative from 3rd party vendor
• Physical Resources
– Servers (production and test)
• We were the driving force behind 3rd
party vendor’s functionality
13. Testing, Testing, Testing
• Phase 1
– Between Cerner and gateway only
– Simulated receiving clinics
– Set up scenarios to test gateway alerts
• Phase 2
– Contacted alpha clinic software vendor
– Set up testing environment with them
– Tested modality by modality
14. Implementation
• One modality, one message at a time
• Daily status calls
• Vendor/Customer gave approval to send next
modality messages
• 3rd party gateway vendor remote support
• Initially needed to work closely with
gateway system’s vendor
– Now only require very basic maintenance
support
15. Timeline
• Initial timeline 2 months
• Chose alpha site and went live in 2004
• Present state, new clinic go-live can be
done in three days:
1. Clinic contacts HIS with list of physicians
(dependent on their hardware/software setup)
– HIS sets up VPN and builds physicians on gateway
2. Send test messages to check connectivity
3. Go-live
16. Current Process
• Verified result or posted transcribed
note triggers result message that is
routed to interface
• Interface sends all messages to gateway
• Gateway prunes messages and routes
only to participating physician offices
• No paper, scanning or filing is required
at either the hospitals or clinic
• Multi site : multi clinic
20. Particulars
• System send 4800+ messages daily to
gateway
• After pruning, gateway distributes
2000+ messages to clinics
• 90 physicians practicing at 12 clinics
receive electronic reports
• Many have opted out of paper reporting
21. Particulars Continued
• Each clinic is free to choose whatever
office management package is suitable
• 4 different vendors are connected,
representing approximately 80% of
available vendors
• Physician account builds and
maintenance are very easy, nothing
changes at interface level
22. Legend
- included in Data
Integration initiative
- complete
- future
EPR Pyramid Now
General
Lab
Notes
Dictation
&
Transcription
Peri-Operative
Care
Patient
Scheduling
Chart
Tracking
Chart
Coding &
Abstracting
Chart
Deficiency
Chart
Viewer
Radiology
&
Nuclear
Med.
Patient
Registration
Blood
Bank
Chronic
Disease
Mgt
PACS
Management
Reporting
Electronic
Signature
Pathology
Orders
AutomationPharmacy
ED
Patient
Tracking
Document
Imaging
Cardiac
Care
Mgt
Critical
Care
System
Problem
List
Bedside
Care
Rules &
Alerts
Clinical
Documentation
Clinical
Pathways
Common
Charting
Practices
Community
Services
Home
Care
Regional
Hospitals
LTC Facilities
Adverse
Drug
Events
Clinical
Decision
Support
Physician
Order
Entry
Family
Physician
23. Lessons Learned
• We started before the wave of office
management vendors hit clinics
• Control of hardware/software set up and
configuration at the clinics is not in our
hands
• The time spent creating standard
specifications is key to success
24. Lessons Learned Continued
• Maintaining constant connectivity
through VPN problematic
• Distributed data model by far most
robust
• Consistent change control from vendors
is required
25. Lessons Learned - Clinics
• Vendor support
• Type of connection required
– Centralized server is most stable at this point
• Talk to other clinics that are live with Cerner
feeds
• Talk to hospitals that are sending Cerner
results
26. Next Steps
• Expect to perform routine hardware
and software upgrades
• Seeing more inquiries from more
clinics
• Can envision same model to send
messages to other corporations,
hospitals, LHINs
• No limit on message types