Healthcare Protocols and other Tech

Phase I Meaningful Use for Pediatric Practices: The Need to Change or Modify Practice Processes

May 18, 2012 in Blog, Healthcare Protocols and other Tech by support Team  |  Comments Off on Phase I Meaningful Use for Pediatric Practices: The Need to Change or Modify Practice Processes

I was on the phone with one of our valued customers this morning discussing Phase I Meaningful Use and the details on the “how” related to Meaningful Use. The overall goal of Health and Human Services is that providers utilize a certified E.H.R. in a meaningful way. A group of individuals invested months of discussions and feedback to obtain a list of parameters. One challenge for the group is to provide a universal list that applies across all fields of medicine. Some of the parameters in Pediatrics only apply to a certain segment of the population. For example, smoking status is for patients greater than 13 years of age. There are core measures that each provider needs to meet the benchmark for all these measures during the 90 day period being measured as well as selecting a list of 5 of the 10 menu measures.

A good E.H.R. system should provide a simple manner for a physician and/or Practice Administrator to evaluate performance of each of these benchmarks as well as very easily ‘drill down’ to identify how to correct/update patient data associated with the measure. How to use a meaningful use dashboard should take minimal training and review. The E.H.R. vendor should be able to guide an individual in the practice on the process via a web meeting or teleconference. So if you selected the ‘right’ E.H.R. system for Pediatrics, using the software and monitoring meaningful use should be straight forward.

The ‘tough’ part of Meaningful use: Changes to how the practice operates. For example, most practices did not record language, race and ethnicity as part of their intake/demographics. This needs to be captured for over 50% of patients seen during the 90 day measurement period for Phase I. If your E.H.R. system is well design, the practice should be able to click on a link and show the patients that do not have this information during the 90 day period. The most efficient way to enter this information is to capture the data when the patient visits the office. The “ah-ha” moment for many individuals is when they first run a meaningful use report, then they make the changes to their office flow and intake forms as needed.

Some questions to ask related to Meaningful use and your Pediatric Practice: Are we entering all medications in the system and sending medications via electronic prescriptions? Do we list the problems for each visit and maintain the patient problem list? Are we maintaining our Medication list and Allergy List? Does our standard protocol for demographics include recording smoking status of patients >13 years of age? Do we record vitals on each visit? Can we connect to the immunization registry? Are we connected to the lab companies that we send the majority of our labs?
This is not meant to be an a complete list of questions but a list to stimulate thinking around meaningful use. There are many resources, websites and references to obtain detailed information. Good luck on meeting Phase I Meaningful Use!

A quick comparison of the 5010 Eligibility changes

October 12, 2011 in Healthcare Protocols and other Tech by andrew  |  Comments Off on A quick comparison of the 5010 Eligibility changes

There’s been much hype around the change to 5010 from the current 4010.  The 270 eligibility files are affected by this move.  A quick look of the changes with examples can be found on another bloggers site found here.

A good excell spreadsheet with some comparisons can be found here.

High Level Interoperability

October 12, 2011 in Healthcare Protocols and other Tech by andrew  |  Comments Off on High Level Interoperability

Alot of people see healthcare technology as being a magical land where information is shared seamlessly between applications.  In some cases this is true.  Where standards exist and are adhered to, exchange can be very beneficial to both patients and physicians.  Until all the physical connections are available however, seamless interoperability is still fiction.

Take a look at a post by a Microsoft employee explaining how Microsoft’s Health Vault can play a role in interoperability.

Programming Healthcare Silos

The Transcript is below

Programming Healthcare Silos – Presentation Transcript

  1. Vaibhav Bhandarivaibhavb@microsoft.com(Microsoft, Health Solutions Group)
    across
    Programming Healthcare Silos
    ^
    ?
    @vaibhavb#oscon #silostalk
  2. Agenda
    Challenges of Health IT
    Standards exist but..
    Open Solutions Exist
    Opportunities in Health IT
  3. Silos of Health Information
  4. Silos in the Enterprise – “On the Floor”
    Electronic Medical Record
    Nursing Workflow/ Documentation
    Clinical Notes
    Emergency Department
    Procedure Documentation
    ICU/Critical Care
    OR Management
    Dictation
    Pharmacy
    CPOE
    Advanced Analytics
    Cardiology
    Labs
    Medication Administration
    Hemodynamics
    Pathology
    Imaging
    Charting
    Medication Dispensing
    RIS
    Orders
    Image Distribution
    PACS
    Mobile Data
  5. Silos in the Enterprise – “Behind the Scenes”
    Contract Management
    Enterprise Scheduling
    Claims Management
    Financial/ERP
    Business Decision Support
    Inventory
    Medical Records Coding
    Purchasing
    Revenue Management
    Document Imaging
    Bed Management
    Registration
    Transcription
    Call Management
    Staff/Nurse Scheduling
    Outcomes Management
    Physician Practice
    Access Management
  6. Meaningful Use
    ICD-9 to ICD-10 Translation
    SNOMED-CT
    Master Patient Index
    EMR/EHR
    IHE
    HL7
  7. Meet Jim
  8. Jim’s ER visit..
  9. Lab
    Emergency
    EMR
    HL7 Lab Order
    MSH|^~&|EMERGENCYEMR|RC90|INSIGHT.LAB|GUH.ER|20080114085834||ORU^R01|H20010816374944.7274|P|2.1|1
    PID|01||1430043|1572c552-f02b-49bf-b7e2-acc74765cb3e|SMITH^JIM||19790127|F||1||||||||cfd9ce6b-dc81-459d-9415-7913eb4635ec|804171277
    PV1|01|O|TPC||||331|||||||HIS|||331|O||||||||||||||||||||||||||20060721|19990921
    OBR|1||1234^LAB|88304
  10. Lab
    Emergency
    EMR
    Lab Result
    MSH|^~&|EMERGENCYEMR|RC90|INSIGHT.LAB|GUH.ER|20080114085834||ORU^R01|H20010816374944.7274|P|2.1|1
    PID|01||1430043|1572c552-f02b-49bf-b7e2-acc74765cb3e|SMITH^JIM||19790127|F||1||||||||cfd9ce6b-dc81-459d-9415-7913eb4635ec|804171277
    PV1|01|O|TPC||||331|||||||HIS|||331|O||||||||||||||||||||||||||20060721|19990921
    OBR|1||1234^LAB|88304
    OBX|1|CE|88304|1|T57000^GALLBLADDER^SNM OBX|2|TX|88304&MDT|1|MICROSCOPIC EXAM SHOWS HISTOLOGICALLY NORMAL GALLBLADDER TISSUE
  11. Creating & Processing Lab Order
    HAPI HL7 Parsing Library
    http://hl7api.sourceforge.net
  12. X12 Message for Eligibility Request
    ST*270*1234*005010X203~
    BHT*0022*13*10001234*20060501*1319~
    HL*1**20*1~
    NM1*PR*2*ABC COMPANY*****PI*842610001~
    HL*2*1*21*1~
    NM1*1P*2*EMERGENCY CLINIC*****SV*2000035~
    HL*3*2*22*0~
    TRN*1*93175-012547*9877281234~
    NM1*IL*1*SMITH*JIM****MI*11122333301~
    DMG*D8*19430519~
    DTP*291*D8*20060501~
    EQ*30~
    SE*13*1234~
    Lab
    Emergency
    EMR
    Health Plan
  13. X12 Response for Eligibility Request
    ST*271*1234*005010X203~
    BHT*0022*13*10001234*20060501*1319~
    HL*1**20*1~
    NM1*PR*2*ABC COMPANY*****PI*842610001~
    HL*2*1*21*1~
    NM1*1P*2*EMERGENCY CLINIC*****SV*2000035~
    HL*3*2*22*0~
    TRN*1*93175-012547*9877281234~
    NM1*IL*1*SMITH*JIM****MI*11122333301~
    DMG*D8*19430519~
    DTP*346*D8*20060101~
    EB*1**30**GOLD 123PLAN~

    Lab
    Emergency
    EMR
    Health Plan
  14. Jim’s Ready to Go Home
    Lab
    Emergency
    EMR
    Health Plan
  15. CCR For Jim’s Visit
    Lab
    Emergency
    EMR
    Health Plan
  16. CCD or C32
  17. HealthVault Interaction
  18. Direct To Clinical
  19. Data In Jim’s Account
    Jim
    Lab
    Emergency
    EMR
    Health Plan
    Jim
  20. NHIN-D
    @ HealthVault address
    Easy integration through SMTP S-MIME
    Exciting Future
  21. HealthVault Medical Imaging
    • Applications can upload large files to a users’ HealthVault record
    • http://bit.ly/hv-medical-imaging
  22. HealthVault Client & Mobile Applications
    Client Applications
    http://bit.ly/HV-client-app
  23. Leaving the Clinical Silo
    Clinical Silo
    While in enterprise your application need to comply with HIPAA 5010
    When Jim log’s in to HealthVault then the data is flowing in to consumer domain
    Lab
    Emergency
    EMR
    Health Plan
  24. HealthVault Open Source Resources
    Community Promise
    Open Source SDKs
    Java : CodePlex
    Ruby : RubyForge
    Python : Google Code
    PHP: SourceForge
    Reference License .NET SDK
    http://msdn.microsoft.com/healthvault
  25. Connected Health Platform Open Source Resources
    Microsoft Health Common User Interface (MSCUI)

    • Microsoft Public License (MS-PL): http://mscui.codeplex.com/license
    • Main site: http://www.mscui.net
    • Toolkit: http://mscui.codeplex.com

    IHE Cross-Enterprise Document Sharing XDS.b

    • Microsoft Public License (MS-PL): http://ihe.codeplex.com/license
    • Main site: http://www.microsoft.com/HealthICT
    • Toolkit: http://ihe.codeplex.com

    Clinical Documentation Solution Accelerator (CDSA)

    • Reference License for CDSA Toolkit: http://code.msdn.microsoft.com/cdsa/Project/License.aspx
    • Main site: http://www.mscui.net/CDSA.htm
    • Toolkit: http://code.msdn.microsoft.com/cdsa
  26. Takeaway
    Lots of opportunity to bridge the silos and empower the patient with open technologies and platforms!
  • Thank You
    Be Well. Be Protected.