Health Information Exchange – as an Entity and a Means of Communication (part 1 of 3)

Posted on behalf of Christel Fowkes, Regional Sales Manager

The term “Health Information Exchange” (HIE) continues to symbolize a critical means of communication in today’s complex healthcare environment.  In order to understand the necessary workflows, technologies and communication protocols to support HIEs, it is important to think about the Health Information Exchange (as a noun) and Health Information Exchange (as a verb).

The number of HIE’s (the noun) has expanded tremendously across the states but in order for these HIE’s to truly facilitate better patient care and clinical outcomes from a communication and collaborative perspective, there is a need for efficient and effective Health Information Exchange (the verb).

Although Electronic Health Record adoption has grown tremendously over the past few years, many providers continue to rely on paper, phone and fax to exchange patient information between and among organizations.  As primary care physicians are expected to do a better job of care coordination and collaboration, it’s important to understand the various protocols and standards for automating this health information exchange.

One of the ways to quickly, securely, and cost effectively transport health information electronically is via Direct Messaging.  Direct Messaging is an initiative promoted by the Office of the National Coordinator (ONC) and was adopted as the key information exchange technology required to comply with Meaningful Use State 2, and soon to be Stage 3.  Direct Messaging uses proven secure standards that have been used by other industries for years and add some additional healthcare specific standards.

The below terms and definitions are important components, contributing to the Direct Messaging Architecture, as the health care community continues to enhance and perfect the way health care data is electronically exchanges.

Direct (also known as Direct Project; Direct Exchange; Direct Secure Messaging) – a national encryption standard for securely exchanging clinical health data via the Internet.  The standard specifies the secure, scalable and standards-based method for the exchange of PHI (Protected Health Information).

The Direct project specifications use SMTP (Simple Mail Transfer Protocol) as the backbone protocol between HISPs ( Healthcare Information Service Provider).  Organizations join HISPs in order to locate a recipient’s Direct address, securely encrypt the information and ensure the information is delivered.  Think of a HISP as an Internet Service Provider.

STA – ( Security Trust Agent)  The encryption of patient data can be performed by the user’s software system or by the HISP.  The system performing the encryption is called the STA.

SMTP – Stands for Simple Mail Transfer Protocol.

S/MIME (also known as secure MIME) – secure email standard used for the exchange of encrypted emails.

The benefits of Direct Secure Messaging are undeniable and numerous. It can replace obsolete, non-secure faxing, phone, mail, and other courier methods for delivering PHI. It helps reduce the cost for physician offices and hospital medical record departments, when sharing PHI amongst a patient’s care stakeholders.  In the process of leveraging simple, secure standards, it also supports providing structured data for importing into electronic health records (EHRs).

With all of these benefits, it shouldn’t be a surprise that the number of Healthcare Organizations (HCO) served through DirectTrusts’s HISPs increased 62% in Q3 2016, with the total number of HCOs operating under DirectTrust surpassed 69,000, and the number of Direct Messaging addresses have grown to over 1.3Million, averaging over 20Million data exchanges each quarter.

Has healthcare finally solved the Health Information Exchange puzzle? Or, can we still do better, faster, more seamless data exchange for patients, providers, and communities?

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Web Services 101 for Interface Engines

Posted on behalf of Marianne Soucy, Manager of Client Education Services 

What is a webservice?

  • A webservice is a way to, unattended, interact with a web based receiver of information.
    • It communicates from one machine to another, with the expectation that a user is not sitting at the screen supplying information (like a user would be with a regular website)
  • A webservice is a collection of open protocols that are designed to allow different technologies to interact and supply and receive information, ie to exchange data.

What terms do I need to know?

  • There are several common terms you should understand when discussing a web service
    • XML – a web service uses XML to tag data, in order to put all the needed data into a universal, commonly agreed upon format between the systems that are communicating. XML can tag each field of data to label it, making it a good choice to pass the data between systems.
    • SOAP – Simple Object Access Protocol – a protocol for sending and receiving messages between applications. Consider it something like wrapping a message in an envelope. It allows us to deliver the message via defined protocols.
      • Probably 80% or more of the interfaces we are seeing in Healthcare use SOAP transmission
    • JSON – JavaScript Object Notation – another open standard format that allows transmission of messages. Another form of “Envelope”.
      • Maybe 10% of what we are seeing in the field is JSON
    • WSDL – Web Service Description Language – a document that describes a web service (kind of like an HL7 spec) and tells you how to access and use its methods. This document gives you a blueprint on what the web service will need for you to interact with it.
    • FHIR – (Fast Healthcare Interoperability Resources) another emerging technology we anticipate will change the above ratios Technically, FHIR is designed for the web; the resources are based on simple XML or JSON structures, with an http-based RESTful protocol where each resource has predictable URL.

What information will I need to know to set up a Web Service in Healthcare?

  • The URL of the webservice
    • The URL of the WSDL is also useful. Often, that can be found by taking the URL above and placing ?WSDL after the .asmx in the URL for example:
      • http://www.webservicex.com/globalweather.asmx = the URL you will send to
      • http://www.webservicex.com/globalweather.asmx?WSDL is often the WSDL that will give you the specifications of what the service is going to be looking for, what strings and parameters it is using, etc.
        • Not all Web Services will give you a WSDL, but it makes setting things up WAY easier!
      • Do I need a certificate
      • Do I need a username and password
      • What parameter(s) does this web service expect me to supply to them

LINK for a good explanation of this :

http://www.webreference.com/authoring/web_service/index.html

How do I check out a Webservice I want to set up?

We are going to use a simple example, showing how to get a Webservice to give us back the weather for a city and country.

  • First, we are going to test the URL to see if it is present and working.
    • Open Internet Explorer and plug in the URL of the Webservice like shown:
    • http://www.webservicex.com/globalweather.asmx
    • Click GetWeather and put in Madrid and Spain (this doesn’t work for all countries, please do use Madrid)
      • In theory, this is what we want our fake web service to do. We want to give it 2 parameters, and for it to give us back an answer
      • In an interface engine, we would be giving them something, like an HL7 message, or a patient ID and a test code result, and they would be giving us back an ACK, in real life terms.
    • Next, we are going to test the WSDL to see if it is present and working.
      • Open a new tab and type : http://www.webservicex.com/globalweather.asmx?WSDL
      • This should give you back a schema, a specification explaining what it needs and wants.
      • This tells me that the MethodName I need to pass will be GetWeather, and that it will expect TWO parameters, a CityName and a Country Name.
      • Many interface engines, such as Express Connect, will make this easy in a wizard later!!

webservices 101 pic 1

  • For less simple examples, we need to consider the following:
    • Do we need to install a certificate?
    • Do we need a username and password?
  • Let’s install a certificate:
    • This is a website that needs a certificate. I can install it this way – click the LOCK icon in the IE browser. Click View Certificates

webservices 101 pic 2

  • Click INSTALL CERTIFICATE

webservices 101 pic 3

  • Browse and put it in the PERSONAL STORE of the user – Or as directed by your vendor as to where to put it.

webservices 101 pic 4

SOURCE INFO and useful links:

Some generic web services to play with :

http://www.webservicex.net/ws/default.aspx – click the name of any web service, I use the GeoIPService one to test a simple pass of one parameter.

This is what a WSDL looks like : http://www.webservicex.net/WeatherForecast.asmx?wsdl

Info on Web Services: http://www.webreference.com/authoring/web_service/index.html

Microsoft HL7 Web Services info: https://msdn.microsoft.com/en-us/library/ms954603.aspx

The main things to remember about a WSDL file are that it provides you with:

  • A description of a Web service
  • The methods a Web service uses and the parameters that it takes
  • A way to locate Web services
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“10 things that will kill all Healthcare Providers if they don’t learn about it – NOW!”

Posted on behalf of Eric Tallberg, Sales Engineer

Have you been seeing these catch-headlines of late on the Interwebs? They look ominous enough and often decry the worst possible scenario almost daring you NOT to click the link. At this point, for most of us, we know this turns out to be little more than 10 things we already knew with some one-off wrinkle thrown in to make us almost think the page was worth going to except for all the Right-Arrows we need to click to see the next item. All the while, more and more ads and pop-ups appear on the screen. I promise you that any that pop up here were not my doing, nor the intended act of my employers! However, my headline seemed to grab your attention, so it must still work!

I wonder if that’s how a lot of CIO’s feel when reading their inbox. There are 100 new emails an hour for many, and 99 are probably another one of us vendor types trying to get their attention. Or a doctor who is getting notified with faxes from hospitals about their patients because of every nit-picky action taken within the hospital walls that they think the provider needs to know. (Who faxes these days anyway??)

Over-saturation of electronic data in everyday life is about to become the same problem in healthcare. The intent of Meaningful Use and electronic data is to simplify lives. As the current state of simply reading news articles with comments below are showing, more is never better when it comes to electronic data. In fact, we need to find more and more products to weed out the “fake news” as much as we need anti-virus.

Fortunately, there are some products out there that can help alleviate one headache, specifically for doctor offices who are being inundated with way too (many faxes??) much data. Products that are part of your Interface Engine that have the capability to discern what data REALLY needs to be provided to offices and even better, can be tweaked by their own staff! You have the ability to control the data that is sent to your own offices if you’re an office outside of a hospital, or as a member of the hospital, determine who needs to be notified of patient updates, and allow them to dictate the specific mode of alerting, what data to send, and whether or not to use secure means of notification.

Summit Healthcare Services, Provider Alert is one such application that has allowed hospitals in California to reduce calls to their Medical Record staff from 150/day to virtually 0. Data is automatically sent to the providers who have secured access to this data and are even able to securely share some data with other specialists. Adding in Imprivata’s Coretext secure texting solution, Provider Alert will have the ability to notify provider staff of significant patient events, be it admissions to the ER, lab results which need immediate notification, or the unfortunate event of a patient’s passing.

CCDA documentation is another strange issue. It seems we all wanted to ensure patient data can be transmitted between care facilities and a great idea with the Continuity of Care (Document Architecture) is the latest machination of data transmission. However, many are finding that the multi-page document which may include a patient’s entire history are simply way too much data. Again, there are ways to reduce this with the right tools. For hospitals, a good Integration Engine should have tools to reduce the overabundance of information contained within these documents. Summit has the Summit Exchange platform which has an integrated mapper which can cull out unneeded data based on rules you get to dictate in terms of eliminating that data. Providers and hospitalists get to see what they need from these sometimes hefty documents instead of trying to read through the entire document to determine if they need to amputate, or simply give an anti-biotic! (Oops! did I just over-exaggerate again?)

I don’t have 8 more life-saving options to give today so I guess my headline might have been misleading. Sorry about that. But, as there are solutions are out there for virus protection, and I’m sure someone’s working on a “fake news” filter already, there are a few companies out there who are thinking ahead and mitigating the “electronic data overload” providers and hospitalists are already or soon will encounter. I do think are farther ahead of that game.

For more information on how Summit Healthcare is working to reduce this data overload, and hopefully avoid unnecessary amputations, please visit Capture

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Summit Provider Exchange – Tips and Tricks

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

Summit Provider Exchange is a flexible bi-directional physician EMR integration platform.  It gives hospitals tighter control over patient registration and order management while enabling bi-directional physician EMR integration.  Below are some tips and best practices we’ve learned from working on many of these implementations and speaking with some of our power users.

Click to Match Speed

Have you or your users noticed the click-to-match response time has slowed over time?  The speed of the click-to-match query is entirely dependent on the amount of ADT data stored.  You are probably storing far more ADT’s than you actually need.  Chances are, you would never want to release an order attached to a patient registration from last week.  From our experience, almost 100% of orders are attached to same-day registrations.  So you don’t need to store ADT’s back 30, 15, even more than 7 days.

Our recommendation is to store your last 3 days of patient registrations.  This setting is controlled by an entry in your Provider Exchange SQL table.  In your PE database, there is a table called tblAppOptions.  In this table, you will find the field purgeDaysADT.  This is the number of days ADT’s will be stored to allow users to match orders to them.  Set this to a lower number and you will find your click-to-match speed improving greatly.

Provider Match

There are a number of ways to restrict incorrect orders from being released when you are not ready for them.  Most administrators know about the service date ranges and add-on order settings.  You may even be utilizing Location Matching, releasing orders only to the relevant registration locations.  But if there are still some orders being matched and released to incorrect admission messages, there is another, lesser used option for you.

In the Provider Exchange Application Options, select the Order Release tab.  Halfway down, you will find an option called ‘Release Orders By Provider’.  When selected, this will release orders only when the Ordering Provider (OBR.16) in the order message matches the Attending Provider (PV1.7) in the patient registration.  Before selecting this, you’ll want to check with your registration team and confirm if they typically assign the ordering physician as the attending physician.  If so, this can be a great check for order release.

Jeff Blog pic 1

Custom Match

After setting your proper date ranges, location and category settings, and making use of the Provider Matching, are you still seeing a few orders release when you don’t want or expect them to?  A new feature in Provider Exchange gives you the ultimate flexibility.  It allows you to define your own, custom field to evaluate for order release.  In the Application Options box above, you can see it listed as ‘Custom Field Matching’.

This option allows you to choose any field you want in the ADT to be evaluated before matching and releasing an order.  An example of this would be using Patient Type or any other field that is not a preexisting option in Provider Exchange.  Some of our more creative users have setup an admissions query in their HCIS to trigger the release.  Custom Field Matching can give you the flexibility to address just about any order release issues you have come across.

Results Tab

Are you making proper use of your Results tab?  This feature was added in Provider Exchange 1.3 and allows you to view the result messages that match the orders that came through Provider Exchange.  It can work as a good first troubleshooting step if one of your Physician Offices has reported missing results.

Jeff blog pic 2

So how do you control what results are evaluated for Provider Exchange display?  This is actually done in Express Connect.  For each interface you would like to send results to Provider Exchange, you will need to select this interface in Express Connect, choose the “Advanced Settings” tab, and check the box that says “Log Messages to Provider Exchange Database.”  Best practice is to select this setting on your inbound results interfaces, as this will give you the largest amount of unmodified result messages.  Depending on what types of orders you are processing through Provider Exchange, you will probably want your main LAB results feed and RAD results feed.

Jeff Blog pic 3

Hopefully you’re already finding Provider Exchange an important piece of your integration strategy.  With these tips and tricks being used by many of our clients, you can optimize the application to fit your specific needs.

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Interoperability: Removing the Obstacles and Inefficiencies to Actually Improve Patient Care

Posted on behalf of Alyssa Semple, Regional Sales Manager

I was recently traveling in Central America. On the two+ hour ride to the resort, for which I hired a driver, I sat back and took notice of what I thought was exceptional skill on the driver’s part. I thought his ability to finesse the two lane road, calmly weaving and bobbing amongst the other vehicles, traveling bi-directionally, was exceptional. It appeared to be perfectly, instinctually timed. There was no honking, no road rage, and not a fender bender in sight. As the trip progressed, though, I began to notice that it wasn’t just the driver’s skill. Everyone on the road was playing a part, and acting as one, as part of something bigger. The other vehicles slowed down to allow us to pass when an oncoming vehicle approached. They made space, we gave others space…it was the perfect melding of divergent vehicles coming together, intuitively sharing information, and working together. Dare I say it? We were all interoperable. (With, of course, a few curveballs and hazards thrown in, by way of cow or goat, but the driver knew how to handle those, as well.)

When disparate entities are interoperable, they work efficiently together, rather than operating as siloes. In Healthcare IT, exchanging of information from disparate EHRs is paramount to improving patient care and saving lives. With the advent of Meaningful Use, the term “interoperability” has become both a buzzword and a feat to accomplish. Sometimes, the real intent – to increase patient safety and patient care by way of providing a complete patient record, improving care coordination and providing positive outcomes – is lost when trying to meet regulatory requirements.

What can we do to overcome the obstacles thrown in our path? Healthcare organizations are working with regulations and technology that do their best to provide an interoperability framework, but the output often falls short of providing the meaningful, useful information that clinicians need to provide care to their patients, at the precise time that they need it.

Organizations need to maximize data communication and flow of information easily and efficiently. With a large spectrum of interface requirements, hospitals are faced with meeting Meaningful Use requirements, connecting to Healthcare Information Exchanges (HIE), integrating with physician offices, patient portals or ACO’s. A scalable technology and Interface Engine with the ability to map and filter information that also provide immediate ROI is a proactive, foundational step towards integration.

Physician office integration (POI) that bridges the disparity of disparate vendor systems. Organizations can further optimize their interface investments with bi-directional physician office integration that complements the work flows of each facility. By closing the loop on orders processing and avoiding paperwork and transcription errors with a solution that is vendor agnostic, patient care is uninterrupted and efficiencies increase.

Providers need information that is useful and meaningful, not a “data dump”. Integration solutions need to be cognizant not only of meeting regulatory requirements, but also of actually providing meaningful information, while also working to improve workflows in the wake of so many standards.­­ Continuity of Care Documents (CCD) often provide inactive data (think pages of blank Problems Lists and old lab results) that makes its review by a provider challenging, at best. The power to parse out inactive data, while also having the ability to meet all interoperability standards and protocols will make this level of integration as meaningful as possible.

Real time, automated notification of hospital events to community-based providers is needed to fill the gaps in care coordination. Discharges from the hospital or Emergency Room often require follow-up care. If not treated according to a discharge plan, readmissions can occur and poor outcomes can result. Alerting providers to these events and providing access to all care information related to the event, not just a CCD, is the foundation of care coordination. At the same time, empowering office staff to have access to the same information to schedule follow up appointments with the patient is critical. Efficient care coordination lowers costs and improves outcomes. It just might expand your referral base, as well.

For information on how Summit Healthcare is helping healthcare organizations meet the challenges that pop up on the road to interoperability in all of these ways, please visit http://www.summit-healthcare.com/.

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The Month After…What Does it Mean for Healthcare

Posted on behalf of Jill Cimildoro, Director of Corporate Accounts

Well, it sure has been an interesting month, to say the least! For over a year now, the world has been entrenched in a highly tense, confusing and dramatic presidential campaign.

The results are in and no matter what political stance you took, President –elect Donald Trump will soon be our president. So, with that said, what does that mean for Healthcare Reform and ObamaCare (the Affordable Care Act)?

What is the Affordable Care Act

In a nutshell, the Affordable Care Act, otherwise known as ObamaCare, aims to provide more Americans with access to affordable health insurance. The ultimate goals being to improve the quality of healthcare, shrink healthcare spending and regulate the health insurance industry. There are hundreds of different provisions included in this very complex, and sometimes (ahem, most of the time) confusing law.

Will Healthcare Reform Change?

Well, no one has a crystal ball, but I think we all agree change is eminent. Whether we work directly with patients on the front lines or in the periphery, whether we are Republicans, Democrats, or Independents, we all want the same thing, right? We want and need to increase the quality of care and in doing so, achieve better patient outcomes. Likewise, we need to accomplish this while spending less. No matter what side of the fence you are on, I think we can all agree on this.

Technology – A Missing Piece to a Very Complex Healthcare Puzzle

If all the political and healthcare reform mumbo jumbo isn’t enough for you, let’s take a look at how technology can play a role in achieving better patient outcomes.

As we are all well aware, we now live in a disparate healthcare community where care teams can span multiple organizations. Options for immediate care now range from the doctor’s office and urgent care centers to clinics and, of course, the emergency room.

Providers, today more than ever, need to have their proverbial stethoscopes on the pulse of their population.

That said, the ability to aggregate data across the continuum of care and access that data in real-time is essential to the Provider’s ability to deliver quality care to their patients.

Better Care Coordination – How Can Technology Help Providers Achieve This?

In order to provide proper patient care, providers need a simple and efficient way to be made aware of clinical events in real-time, and they need to have options in the way they receive this data (Secure Text, Direct, EMR Integration and so on)

A proactive clinical event notification solution which supports seamless clinical event notifications, and communication, while leveraging standard interoperability practices and workflows is paramount. Technology needs to be web-based. And, it needs to deliver real time patient specific clinical event data to a providers care team (providers, care managers, practice managers, payors, and even to sub-acute communities, regardless of whether electronic health record technology is in place or not). Likewise, the information that is presented to providers needs to be meaningful and relevant.

In short, technology is just one of the many puzzle pieces needed in order to bridge the gap, between providing quality and informed patient care. The disconnect between care settings is counterproductive toward the goal of healthcare reform, which aims to encourage higher quality of care and better health outcomes at lower costs. Although our current Healthcare Reform policy will certainly change over the next four or more years, one thing will remain constant; and that is the need to maintain a patient’s continuum of care.

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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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