Interoperability from Coast to Coast

Posted on behalf of Katie Jankowski, Software Engineer

You’re on vacation in beautiful California and decide to go snorkeling off the coast of Catalina Island. You were so caught up in admiring the sea creatures, you didn’t even notice that you were approaching the reef and accidentally collided with it. Now you’re injured and need to get to a hospital as soon as possible.

You finally arrive at the closest hospital and are being triaged. The medical staff is starting to ask you quite a number of questions. Where do you live? When’s your date of birth? Are you taking any medications? Do you have any allergies? Have you ever been injured like this before?

As you’re answering these questions you begin to think ‘Why am I always asked the same things? Why can’t they just get this information from my hometown hospital in Boston so that I can get out of here quicker?’

The short answer is, they can!

Interoperability is a growing topic for the healthcare industry and brings great advancements with it. By definition, Interoperability is “the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged”[1]. What this means is, the California hospital would already have your information on hand from the Boston hospital. The California hospital would already know that you’re allergic to penicillin and would already be looking for an alternative patient care option to ensure a safe recovery. Less time would be spent asking the same questions and more time would be spent treating and recovering from illnesses and injuries. Patients could rest easy knowing that their information is on file and being reviewed by the medical staff once they’re admitted to the facility.

Katie Blog pic[2]

There are a number of EHR systems available for healthcare organizations and interoperability is the movement that allows all of these systems to integrate together, forming a seamless exchange of data. This integration is so important to patient care, so that doctors and healthcare professionals alike are aware of any medical history, allergies or current medications to prevent interactions during the treatment and recovery process. In the cases where patients aren’t able to adequately communicate to their caregiver, this integration can assist with filling in those gaps.

One example of information that can be exchanged is the CCD (Continuity of Care Document). The CCD is basically a one stop shop and has become increasingly popular in the Healthcare IT world, particularly with regard to integration. This document is essentially a summary of a patient’s chart, including information like recent lab results, visit history, demographic information, allergies, and medications among many other customizable features. The CCD is now essential to all healthcare organizations, especially during emergency settings needing quick, accurate, and up to date information on their patients.

Because each EHR has the ability to add their own flare to the IHE specification for the CCD, interoperability allows for each document to still be readable regardless of the EHR system being used. In other words, integration systems are EHR-agnostic and facilitate behind the scenes translation between EHR systems so that each and every organization has legible data for their patients.

Through the use of HISPs, HIEs, and integration systems like Summit Healthcare’s Summit Exchange, Express Connect, Provider Exchange, and Care Exchange products, healthcare organizations are able to exchange data seamlessly and patients can trust that their caregivers are receiving accurate information.

For more information regarding Summit Healthcare products, please visit our website at http://www.summit-healthcare.com/.

[1] HIMSS, http://www.himss.org/library/interoperability-standards/what-is-interoperability

[2] MEDITECH, https://ehr.meditech.com/news/top-10-ways-meditech-is-committed-to-interoperability

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Cerner Health Conference – Healthcare Automation for an Evolving Landscape

Posted on behalf of Jim Abreau – Regional Sales Manager, Summit Healthcare

Are you excited about this year’s Cerner Health Conference in Kansas City? Following one of the most divisive and controversial Presidential Elections in recent history, it would be responsible to reflect on the evolving landscape of healthcare in the United States to try to determine what is coming next and how to best prepare your organization from a technology perspective. Regardless of your political leanings, it is quite clear that the Patient Protection Affordable Care Act (Obamacare) has resulted in the homogenization of the Healthcare Industry. Although it is debatable whether this has improved healthcare delivery, it is clear that we have seen merger activity with insurance payers, EHR vendors and healthcare organizations through the rise of Accountable Care organizations. As these mergers and acquisitions continue, it has presented significant challenges for IT departments to create best practices and consistencies across additional facilities within their electronic health record. This is why I’m particularly energized to be showing Summit’s InSync application during this year’s conference.

There are a whole host of challenges that organizations are being faced with, that impact how an organization manages their data and domains within their HCIS infrastructure. These industry influences are not simply limited to organizational growth through acquisitions or mergers. However, as subsequent mergers and acquisitions are often tied to finan­cial implications, organizations are being faced with assimilating these facilities into the fold. While the assimilation is addressed across the healthcare enterprise, one key area with a significant impact on resource drain is around data and domain management. How can an organization efficiently and cost-effectively standardize their application roll-out strategy to the new facility? How can an organiza­tion seamlessly establish and introduce data standards? Summit Healthcare’s Domain Synchronization tool will provide the primary role in ensuring that Cerner EHR domains remain in-sync, especially between the clinical and financial domains across multiple facilities of IDNs. This will enhance other major project initiatives, like implementing Cerner at newly-acquired hospitals.

Other challenges include high volume data management & control policies; cost overhead of manual processes; mass update processes; corporate compliance standards; and training large staff populations. Cerner Organizations are unique, whereby they are standardly managing anywhere from 4-6 differ­ent Domains – sometimes 10 – simultaneously. In short, this represents a high volume of data. Fur­thermore, there are multiple stakeholders, department leads, and IT representatives responsible for, invested in, and leveraging this data. How can an organization ensure that change control policies are being followed? If it’s mandated that all changes happen first in Cert, then in Prod, is there a way to monitor domain compliance? Do you know how closely synchronized your Cert to Prod domains are or how many discrepancies exist? Summit’s InSync tool not only maps and recognizes where discrepancies exist, it also enables you to automate mass updates to ensure best practices are followed across facilities.

This toolset will provide “soft” and quantifiable “hard” return on investment to healthcare organizations by significantly reducing laborious build effort and automating regression test­ing. The product is designed to enable your IT staff to tightly manage data in or between domains, ensuring full compliance with any organizational, lo­cal or national regulatory requirements. This will pro­vide time and cost savings, reducing the FTE require­ments to manage a system post-production. With all domains built consistently across all facilities in the LIVE environment, healthcare organizations will be empowered to better reduce costs, improve pro­ductivity and provide the highest quality of patient care at every hospital in the system.

As we stand at the precipice of a potential change in healthcare direction with a new Administration, the only certainty for the future is uncertainty. Will the new administration seek to increase funding for the Federal Trade Commission and Department of Justice Antitrust division to help their ability to monitor – what some have argued – anti-competitive practices?  This would be a bold step, regardless of how we feel about it politically. If this course is not taken, it is unlikely that merger activity will slow down. No matter what the outcome is, it is becoming clear that IT departments will continue to be challenged by domain changes and delivering best practices across multiple facilities. Summit’s InSync tool can help your team deliver these results, while saving significant time on manual processes and providing quantifiable return on investment.

Stop by the booth (#323) for a demo and free swag!

About us: http://www.summit-healthcare.com/company-about-us.htm

 

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Takeaways from HealthAchieve 2016 in Toronto

Posted on behalf of Scott Washburn, Regional Sales Manager

I had the pleasure of attending the HealthAchieve Conference on November 7th and 8th at the Metro Toronto Convention Centre.   ​​This award-winning conference and exhibition has been put on by the Ontario Hospital Association for over 90 years.  HealthAchieve works hard to help make sense of a complex and ever-changing health care system.  They embrace thought leadership, inspire ideas​ and pursue innovation by giving health care leaders the opportunity to learn from each other, share ideas, and evolve their perspectives.  This year was no different.

As you can probably imagine our friends north of the border struggle with many of the same problems we do here in the states. Interoperability being no exception.

To give you some background, they have something called LHINs (Local Health Integration Networks). These LHINs work to plan, integrate and fund local healthcare initiatives. In Ontario there are 14 LHINs, each covering a geographic area and comprising many HSPs (Health Service Providers).

One of their more recent initiatives is HRM (Hospital Report Manager). HRM allows clinicians using a qualified EMR to receive patient reports electronically from sending facilities like hospitals and/or Independent Health Facilities. HRM sends the narrative text-based or binary (PDF, etc.) Medical Record and Diagnostic Imaging reports it receives from sending facilities electronically and stores them in a secure folder for pick-up by the clinician’s EMR. The EMR picks up the reports, which are posted to the patient’s record in the EMR and to the clinician’s inbox for review and sign-off.

Here is how it works:

  1. Sending facility creates a report, identifies report recipients and transmits the report to HRM.
  2. HRM converts the report to an EMR standard format, encrypts and deposits the report to the secure folder for each recipient’s EMR.
  3. The clinician’s EMR retrieves the report, decrypts and posts the report into the patient’s record in the EMR and to the clinician’s inbox for review and sign-off.

HRM also allows for eNotifications; sending messages to primary care clinicians to notify them when their patients are discharged from the Emergency Department or are admitted or discharged from in-patient units.

Great, right? Well, yes and no.  It has certainly worked well and by most accounts it has done as intended. However, we often hear from our Canadian clients who need more flexibility in what, when and how they are sending reports, as well as who and how they are notifying electronically. Another issue is, if a provider does not pick up the report, the sender is not notified. Therefore many are duplicating this process via fax until the Provider comes and specifically asks them to stop faxing.

I heard of one story while at the conference of a frequent patient who had bed bugs. Not pleasant, I know. But it was obviously imperative that the appropriate hospital staff be notified immediately when this patient came into the Emergency Room.  Sending an email to their EHR was simply not fast enough.  They needed something more immediate.  They needed a text message sent to multiple people to ensure that the problem was dealt with quickly and discreetly.

As we have experienced here in the states, one size rarely fits all. The key to interoperability, anywhere, is our ability make it flexible, customizable, efficient and timely.

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Laughter is the Best Medicine

Posted on Behalf of Christel Fowkes, Regional Sales Manager

I just returned from the HealthAchieve 2016 conference in Toronto Canada, which is one of the largest and most prestigious health care conferences in North America.  While reviewing the conference agenda, I was thrilled to see that Howie Mandel was a featured speaker, since I’m a big fan and one of my favorite TV shows is “America’s Got Talent”. However, I kept thinking how is he is going to speak for 90 minutes on health care.  Given that he’s a Canadian comedian, I assumed he would simply entertain the audience with a comedy act given the proverb that “Laughter is the best medicine”.

As Howie began speaking to several thousand people, he said very loud and clear, “I’ve suffered from mental health illness my entire life… I was born in 1955 in Toronto, Canada, and having mental health issues and going to a psychiatrist was not the norm. Society has always attached a stigma to mental health issues…”   He went on to discuss how important it is for everybody involved in healthcare today to have compassion and to understand the incredible impact mental health has on the overall well-being of the patient.  He said, “It’s easy to tell somebody that you are going to take an hour off to go the dentist.  But if you happen to tell your co-workers that you are going to see your psychiatrist for an hour they will think you are a crazy person…”  Howie did have the audience laughing several times as he shared many stories about his ongoing struggle with OCD and ADHD.  I found him to be heartfelt and hilarious as he took questions from the audience.  One member of the audience was a CEO at a hospital and shared how he recently blogged about his personal struggle with mental illness and the positive impact his story has had on his hospital employees and the patients they care for.

One of the most important things patients, families and health care providers can do is to communicate and to be honest about whatever mental health issue they are dealing with.  According to the World Health Organization, as many as 450 million people have some sort of behavioral disorder or mental illness. Mental illness isn’t a disease of the weak and it isn’t a cry for attention. It is a serious, life-changing illness.

During Howie’s presentation I started thinking about today’s healthcare environment as it relates to patient data exchange and interoperability.  Often times, patients are too embarrassed or afraid to disclose their mental illness to their healthcare providers.  As the industry continues to push for more sharing of data, it’s important that the clinical community has the necessary physical and mental health background on its patients.

In keeping with meaningful use requirements, the Direct standard is being used to exchange health data in a secure manner.  However, in order for clinicians to best utilize this data, they should probably know if the patient is suffering from any underlying mental health issues.

Those of us in healthcare IT can keep up with all of the communication protocols and emerging health IT standards, such Fast Healthcare Interoperability Resources (FHIR), but at the end of the day, it’s critical for clinicians to receive not only secure data but comprehensive data including mental health as well.

By the end of 2016, it is estimated that healthcare organizations connected to Direct Trust Health Information Service Providers (HISPs) will increase by 62 percent over the previous year.   As Interoperability and Connectivity continue to drive health care organizations to share more patient data, my sincere hope is that people like Howie will continue to drive and motivate others to share their mental health struggles and not be afraid to share their data with others.

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Leveraging SharePoint and Project for Collaborative Project Planning

Written by a Project Coordinator at Summit Healthcare

Is the project manager the only one managing the project plan file in your Company? If your answer is yes, consider that it puts the onus on them to collect the tasks, chase down detailed plans or decide the task list on their own.  Since Project is not a part of the Office Suite, most stakeholders likely do not have it installed, even more do not have the training to use the software, or more importantly the training to use it as a collaboration tool.  However, we can communicate and collaborate as a project team when we use server software designed for these purposes, particularly when we use collaborative software such as SharePoint.

The starting point in SharePoint would be a team site which is shared with the departments and all stakeholders involved with projects and the management of projects. SharePoint task lists is a web page on the intranet where all the project team members and stakeholders can see it. Everyone has a real-time view into the status of the project: who’s doing what, what’s completed, and what tasks remain. Best of all, they can all edit and add tasks to that list, contributing their perspective and details to the project plan.  These task lists can be stored in the same location as other project-related documents.  We can use a task list as an entry point for everyone involved to add their tasks and collaboratively plan the project together. Team members can also maintain and check off tasks as they complete them.

SharePoint provides some rich collaborative capabilities that give us a compelling reason to start our project planning process with a SharePoint task list. However Project also has some rich project management features we might want to utilize. Fortunately Project has the ability to create a project plan from a SharePoint task list. The feature imports the task list and synchronizes the SharePoint task data within Project.  Once the project manager finishes working with the project tasks, they save the file and it synchronizes the data back with the SharePoint task list.  Project Management dashboards with KPI web parts will allow reporting to management or customers to efficiently see and analyze key project metrics.

Leveraging SharePoint and Project provides the best of both worlds, and it uses a simple SharePoint task list. Everyone on the team typically will have some familiarity with SharePoint task lists, or at least they can figure them out pretty quick. They can then contribute and help shape the project, and they can help make sure it reflects reality. This process helps to involve the project team and the stakeholders better, and it keeps them engaged with the project. This also provides stakeholders, employees and other key resources access 24×7 to project status, issues and risks.

It is imperative in the Healthcare IT business that automation of the project management processes and tools be integrated with the workflow of the business. Leveraging SharePoint and Project empowers individuals to efficiently share and centralize information.  As well as display relevant reports (is the project on schedule? what tasks are ahead/behind, resource utilization, etc.) to executive stakeholders whenever they want it without having to rely on email.

Posted in Business Continuity, Healthcare Systems Integration, Interoperability, MEDITECH, Uncategorized, Workflow Automation | Tagged , , , , , , | Leave a comment

Building Custom Connectivity Maps for Summit Express Connect 9.3

Posted on behalf of Hollis Marek, Director of Software Development

Role of an Interface Engine

Hospital information systems are made up many different pieces of software, all with their own data stores, and yet they all need access to the same patient information. In order to accommodate data sharing these vendors all implement message based interfaces, typically in HL7 or a similar standard, to pass information back and forth.

These interfaces can cost several thousands of dollars to set up, and no two vendors seem to have the same interpretation of the standards. This leads to further complexity and costs as one or the other is forced to modify their software to accommodate these differences.

Enter the interface engine, which can sit in the middle of your enterprise like a hub, splitting messages to as many vendors as you want and modifying the messages as needed for each vendor.

Solution Overview

While most of these interfaces tend to use TCP/IP or file shares to transmit messages, you may sometimes find yourself needing to communicate in a new way. In order to accommodate this, Express Connect version 9.3 added support for using the Summit Apex Mapper to develop customized connectivity types.  To do so you will need to create a map along with any custom assemblies that may be needed.

In this example we will use the new Web Service control to demonstrate how to set up and configure a dynamic connectivity type.

Express Connect Workflow

To the end user, your new map will show up in the Connectivity Type dropdown alongside TCP, File, etc. Once selected, the Express Connect UI will dynamically generate the fields for the Properties and for the Advanced Settings tab based on the contents of the map.

Engine Workflow

Inbound interfaces will operate on a timer, running the map once every two minutes. Once a message is found the map can be run again with a different Action parameter to do any cleanup (send an acknowledgement, delete a message from a mailbox, etc.).  This is defined more below.

Outbound interfaces operate in two ways, one is to use the same timer method as inbound interfaces. This allows an outbound interface to poll for asynchronous acknowledgements. The other way is the same as any other outbound interface, a message is taken off the interface queue, run through the interface map and then sent.

Map Settings

In order for Express Connect to properly read the map as a plugin there are a few things that need to be set up in the Map’s settings. Some of these will need to be changed directly within the <MetaInformation> element in the XML for now.

Hollis Blog pic 1

 

  • The <MapName> element is the value that will show up in the Connectivity Dropdown once the map is imported
  • <SourceFormat> and <TargetFormat> should both be set to Plain Text Message.  Note that these one can be set on the Map Properties screen in the Mapper as well.
  • An element named MapType will need to be added to the XML.  The value will be either Inbound or Outbound, indicating which type of interface can use this map.

Parameters

Within the XML are elements for <InputParameters> and <OutputParameters>. Each Parameter has the following XML elements:

  • Id – This is a unique identifier for each parameter.  Typically this is a GUID, however the only real requirement is that it be unique within the map.
  • Values – For list type parameters this will contain a list of values.

User Defined Parameters

Hollis Blog pic 2

 

 

When developing a plugin map you will need to define Input Parameters for any user defined settings required by your map. These parameters will be displayed in the Express Connect UI when your new connectivity mode is selected for an interface.

For now, these will need to be added directly to the XML of the map. The UI has no direct access to a map’s parameters. Add them to the <InputParameters> XML element, and remember to use names that will make sense on the screen.  Parameter names should be enclosed in square brackets ([]).  The parameters will be identified as UI parameters based on the following XML Attributes:

  • Comments: The tooltip that will show up when a user hovers the mouse over the label for this parameter
  • Value: The default value that will appear for new interfaces
  • Group: Determines which tab the parameter should appear on.  A value of “Basic” will indicate the main Properties tab, and a value of “Advanced” will indicate the Advanced Settings tab.  If this element is omitted or if it has any other value, the parameter will not be accessible from the Express Connect UI.
  • Control: Indicates the type of control that will show up for this parameter.  Current options are:
    • ControlSpinner – a numeric up/down or “spinner” control
    • ControlTextArea – a large block of text
    • ControlCertificate – an SSL certificate chooser.  Chooses certificates from the personal store of the currently logged in user
    • ControlFile – a text field with an ellipse that opens a file chooser
    • ControlChoice – a dropdown that will include choices from the Values tag within this parameter as in the following example.

    Hollis Blog pic 3

    • ControlPassword – a text field that uses a * character to mask the user’s input
    • ControlWSDL – WSDL URL Field.  This control has a magnifying glass icon to look up the WSDL url entered and populate dropdowns based on the Dependency attribute
    • ControlWSDLMethodList – A list of methods that may be populated by querying a WSDL web site
    • ControlWSDLParameterList – A semicolon separated string representing a list of parameters to a web service call
    • ControlWSDLValueList – A semicolon separated string representing the values that correspond to the web service parameter list.  Displays the Mapper List control in a dropdown
    • ControlText – a text field (this is the default if an unknown value is present)
  • Dependency: For now this is only used on the WSDL parameters to tie them to other parameters

 Engine Parameters

The Express Connect Engine expects a few specific parameters to be present and will set or read them automatically.

  •  Input Parameters
    • [InputMessage]: For outbound messages this is the Plain Text Message that will be sent.
    • [Action]: Optional parameter that can be useful for interfaces like the Direct interface that have multiple different steps.  Values passed by the engine are:
      • GetMessage – Used when called by the polling timer to check for new messages on an inbound interface, or to check for acknowledgements on an outbound interface.
      • SendMessage – Used when called to send a message on an outbound interface
      • ProcessMessage – Sent to the map after the message polling timer has retrieved a message, can be used to generate an acknowledgement or clear a processed message from the sending system.  In the Direct interface this is used to delete messages from the mailbox after they have been read.
  • Output Parameters
    • [OutputMessage]: For inbound maps this is the message that is being processed, for outbound maps this would be considered an acknowledgement
    • [Result]: A true or false value indicating if a message was sent successfully for an outbound interface or if a message was found for an inbound interface.  For an outbound interface this will be considered to indicate a negative acknowledgement if there is a value present in OutputMessage.
    • [FailReason]: If the map encounters any errors when running it should save them to this parameter.

Variables

In order to access a parameter for conditions or commands in your map, just add a variable with the same name.

Distribution

In order to get your new connectivity type to show up in Express Connect, you can import the new map from the Dynamic Connections tab in the Application Options screen. Detailed instructions can be found in the Express Connect documentation.  If your map uses any custom commands, you can drop the dll files into the Plugins folder at the root of the Express Connect 9 Program Files directory.

Hollis Blog pic 4

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Tackling your Physician Office Integration

Posted on behalf of Jeff Ford, Regional Manager, Client Support Organization

Transmitting orders electronically from a Physician Office into your HCIS is a great way to generate new business, streamline workflow and save paper.  Having done a number of these implementations, we’ve come across a few challenges that almost all hospitals have faced.  If you are able to tackle the five hurdles below, you’ll be well on your way to a successful integration.

Order types

The first thing you’ll want to think about at the beginning of the project is the types of orders that you want crossing electronically into your HCIS.  Summit Provider Exchange along with the Summit Exchange interface engine can handle all order and result types, so the limits will be based on your HCIS and workflow.  Many hospitals with start with LAB orders and then expand to RAD once they feel comfortable with the process.  Both can be implemented at the same time or separately, so you’ll want to discuss with your team early on what makes the most sense for your hospital.

Interfaces needed

So what interfaces will you need to successfully implement this integration?  From the standpoint of your HCIS, you will definitely need an Orders Inbound interface.  Some vendors will receive all orders over one interface, others will split LAB and RAD over two interfaces, so you’ll want to confirm which setup yours has.  Chances are the idea behind this is to get the results for these orders back to the physician, so you’ll need a Results Outbound feed as well.

That last piece you’ll want to consider is patient registration.  Would it be helpful for the patients to be pre-registered when the order is sent electronically from the physician’s office?  Or is it possible that many of these orders will never present at the hospital and, therefore, you’ll end up with a bunch of unused accounts?  If pre-registration would be helpful, many HCIS vendors offer an ADT inbound interface.  You can utilize the Summit Exchange Interface Engine to create a pre-registration ADT message from the information in the physician’s order message.

Interface List:

Orders Inbound (LAB/RAD)

Results Outbound (LAB/RAD)

ADT Inbound (Optional)

Compendium

Now you’ve decided on the order types you’d like crossing and your interfaces are ordered and in place, you’re ready to begin, right?  Not quite.  The biggest delay in Physician Integration projects we see is the creation, development and installation of the compendium.  The compendium is a database or map that is used to translate the Physician’s vendor’s terms into the values used by your HCIS.   Items in the compendium typically include, but are not limited to, Test Mnemonic, Provider ID, Insurance ID and Micro Sources.

The compendium can take up to 3 months to put together and implement, so it is highly suggested that you reach out to your Physician’s electronic ordering vendor even before the project kickoff.  This will allow you to begin the work and be ahead of the game.  Testing cannot start until the compendium is completed and in place.  This work will typically be done by a LAB or RAD specialist at the hospital who is familiar with your dictionaries.

Workflow

There are going to be a number of workflow changes you’ll need to consider, whether this is going from a paper based ordering system to electronic or if this is an entirely new system you’ll be integrating with.  The departments affected most are going to be your Admissions staff, your Scheduling department and, obviously, your LAB/RAD departments.  You’ll want to consider and discuss what changes will be made and who will be managing them.  All of these discussions can lead you into the biggest hurdle, below.

User Buy-In

This is going to be a big change for all involved.  Both the Physicians and your internal clients in LAB, Radiology and admissions have systems in place that they’re currently using and feel comfortable with.  They’re going to be nervous about going away from “paper” and possibly annoyed by a few extra mouse clicks.  It’s important to focus on the positives of your electronic orders integration!  The ROI on this is huge and once LIVE, they’ll see the time and effort it is saving them daily.  Keep everyone focused on the end game and involve all stakeholders early and often so all sides are heard.

Anticipating and preparing for these five hurdles will have you well on your way to tackling this rewarding, mutually beneficial project! To learn more about Physician EMR Integration, join us for a live webcast on Thursday, November 3.

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Ransomware Increasingly Seen in Healthcare IT

Posted on behalf of Alex Casey, Marketing Manager

Ransomware is becoming an increasing concern among many healthcare providers. Cyber criminals have been able to encrypt files resulting in infecting PCs and restricting access to both files and PC access. In recent news, these criminals have also gained the ability to establish connections throughout hospital networks resulting in a wide range of information throughout the enterprise to be encrypted. This loss in data availability – whether lengthy or not – disrupts normal hospital operations and creates a significant problem surrounding patient care.

Choices to Make

Organizations effected by ransomware find themselves in difficult situations and moral dilemmas.  When important data a hospital needs to maintain standard operations is no longer accessible, hospitals have a choice to make. Find some kind of work around and maintain operations with no to limited access data. Or pay into the demands of cyber criminals with no promise of a solution or access key. Lately, we’ve seen many organizations paying the ransom with the hope to restore operations quickly and smoothly.

The Real Impact on Organizations

It’s imperative for organizations to have access to critical information at all times to ensure patient safety and care. Delays and disruption in communication and information may be the difference between life or death in some instances. Other impacted areas may include the inability to access information such as:

  • MARs
  • Census Reports
  • Orders
  • Rounds
  • Index Reports
  • Intake & Discharge Information/Reports
  • Various Monitoring Technologies & Reports
  • Pharmacy and Lab Orders/Results
  • Monitoring/Nursing Stations

Alternative Solutions

Unfortunately, cyber-attacks are just one of many reasons for disruptions in the distribution of information. Although hospitals have been able to recover from cyber-attacks, it does entail a lengthy process, and all expectations of hospital staff to ensure patient care and safety do not falter during this time. All organizations need to have contingency plans in place due to any type of downtime.

The thought of using paper charts just doesn’t cut it in the technology driven world we live in today. Downtime systems now have the ability to leverage existing critical reports within your system, protect that information and distribute it to various pre-determined “downtime machines” located throughout hospitals. These downtime machines allow end users the ability to view or print reports as needed. Not intended to be a long-term solution, these technologies allow staff and clinicians to maintain a necessary flow of information and care during downtime.

For more information on downtime solutions and data management visit www.summit-healthcare.com

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“Mind the Gap!” in Care Coordination

Posted on behalf of Alyssa Semple, Regional Sales Manager

Anyone who has ever been on the United Kingdom’s rail system is familiar with the phrase, “Mind the Gap!” to alert you (incessantly) of the large and looming gap that needs to be crossed in order to safely transfer between the rail car and the platform. While no one ever tells you what would happen if you don’t “Mind the Gap,” it’s pretty clear that falling into that wide crevice would result in a negative experience.

I tend to look at gaps in care coordination the same way. You never really know what you’re in for if you fall into a gap in care – and more importantly – you’re often not even told to be mindful of it. But if it happens, you know it’s likely not to result in positive healthcare outcomes.

What is Care Coordination?

Care coordination is terminology that has buzzed around healthcare discussions for years now. It seems to mean different things to different people, but Meaningful Use is working to herd the masses into some form of standardization. As someone who has worked for over 15 years in Healthcare IT, provides direct care services with a community-based hospice organization, and as the child of a chronically ill parent, my area of interest lies in the marginal ability to address the gaps that exist between hospital events and follow up care.

I have seen and experienced my share of health systems with disparate EHRs and disconnected community providers. In these familiar scenarios, the reality of care coordination has all too often depended upon the diligence of physician office, sub-acute facility staff or even the patient to request records from a hospital, resulting in some sort of faxing or manual exchange of information. That is, if a request is even made. All too often, nothing is done. The patient is discharged and no one is the wiser. Yet, study after study has shown that providing coordinated care from the emergency room visit and hospital admission to discharge and follow-up outpatient care reduces readmission rates, improves patient outcomes and lowers healthcare costs. How to accomplish it in an efficient, proactive way is still alluding the industry.

So, how do you strike the balance between regulatory mandates, provider and consumer needs? You’ll need a framework to accomplish the following:

Promote Care Coordination

Enhance care team engagement between patient, primary care provider, referring provider, care coordinator and/or other team members through notification of a patient’s significant hospital event. This is not just about providing an alert to a responsible provider, but also making the information available to office staff, who are able to take action through scheduling of follow up visits, etc.

At the same time, this functionality will help organizations meet the proposed Meaningful Use Stage 3 requirements for improving the delivery of patient care though real-time electronic notification, and will position an organization for new payment models and ACO shared savings.

Reduce Re-Admission Rates

Through targeted alerting, organizations can prevent potential penalties by providing appropriate follow up care, provide better patient outcomes, and maximize reimbursements.

Lower Healthcare Costs

Integrated care team engagement allows for faster follow up and cost reductions through medication reconciliation, proactive post hospital care and patient education.

Summit Provider Alert

Summit Provider Alert provides electronic delivery of notifications and corresponding data of significant hospital events sent in real time to known members of a patient’s care team, accomplishing the items in the above framework.

By sending actionable information to a patient’s care team, your organization is allowing for the promotion of care coordination, follow up, and reducing re-admissions, ultimately contributing to your organizations’ bottom line and allowing you to remain competitive in the marketplace.

There are many possible scenarios and use cases to execute this type of technology, and Summit Healthcare is the group to help you do just that.

 

Posted in Business Continuity, Healthcare Systems Integration, Interoperability, MEDITECH, Uncategorized, Workflow Automation | Tagged , | Leave a comment

There’s a FHIR in the House, Don’t get Burned

Posted on behalf of Paul J. Actis, Vice President, Research & Development

FHIR DEFINED

There’s a new integration standard in town, and it’s heating up the whole valley.

FHIR (Fast Healthcare Interoperability Resources) takes the best of the existing protocols (HL7 2, HL7 3, CDA…) and brings them into the modern world of healthcare integration.  FHIR presents a number of advantages over the current set*:

  •  A strong focus on implementation – fast and easy to implement (multiple developers have had simple interfaces working in a single day)
  • Multiple implementation libraries, many examples available to kick-start development
  • Specification is free for use with no restrictions
  • Interoperability out-of-the-box– base resources can be used as is, but can also be adapted for local requirements
  • Evolutionary development path from HL7 Version 2 and CDA – standards can co-exist and leverage each other
  • Strong foundation in Web standards– XML, JSON, HTTP, OAuth, etc.
  • Support for RESTful architectures and also seamless exchange of information using messages or documents
  • Concise and easily understood specifications
  • A Human-readable wire format for ease of use by developers
  • Solid ontology-based analysis with a rigorous formal mapping for correctness

FHIR’s closest standard, HL7 v3, did not gain wide acceptance, one of the reasons because of its design by constraint paradigm.   FHIR takes a totally different approach in using the 80/20 rule.   This states that inclusion of data elements (resources) which are most common under normal implementations will be part of the standard and any other custom content will be defined as extensions.

FHIR TODAY

The healthcare interoperability industry is definitely taking FHIR seriously. Numerous initiatives seem to be sprouting daily.   The Argonaut project, SMART on FHIR and, Sync for Science just to name a few. FHIR is being used by over 20 countries and 150 organizations.

While FHIR is gaining broad acceptance, its biggest competitor HL7 v2, has been around for almost 30 years.   Its simplistic model and wide implementation base means v2 will be around for quite some time.  So don’t look for FHIR to replace it, but supplement it as market evolves to meet the needs of the new technology infrastructure.   Mobile, web services, and cloud-based applications is where FHIR’s strength will be most implemented.

FHIR, however, is still in its infancy. It is in its second rendition of Standard for Trial Use (DSTU).  The third draft is set for 2017 and Normative for some time in 2018.  During this time period before Normative, the FHIR specification is subject to change so that is something to be aware of as you are working through your own FHIR initiatives.

Summit and FHIR

As a leading provider of healthcare integration, Summit is committed to be at the forefront of this technology. FHIR is an integral part of our new web and exchange platforms.  Provider Alert implements numerous FHIR resources for its report generation process which will allow for quick onboarding of new document types.  FHIR fits in very well with Summit Exchange’s extensible architecture, providing another transport for data exchange without all the complexity.    FHIR can also be processed within our current Express Connect product.

*https://www.hl7.org/fhir/summary.html

Posted in Business Continuity, Healthcare Systems Integration, Interoperability, MEDITECH, Uncategorized, Workflow Automation | Tagged | Leave a comment