Meaningful Use - Delivery Update · Challenges Message from Senior Management Call 978.539.0734...
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Message from Senior Management Meaningful Use - Delivery Update Jeff McGeath Senior Vice President Surfing the Patient- Generated Health Data Tsunami Ensure Meaningful Use Readiness Amidst Approaching Deadlines Warren General Overcomes IT Implementation Challenges Message from Senior Management Call 978.539.0734 Meaningful Use - Delivery Update Jeff McGeath, Sr. VP of Software Solutions I’ve heard, and I believe, that the time in which we find ourselves in at this very moment is the most stressful period in the history of Healthcare IT. Hospital administrators, clinical leaders, IT management, and all of the analysts who perform various duties inside the hospital have been extremely taxed. We see it at almost every customer site where we engage in delivering our solutions. It has not been an uncommon occurrence for us to hear on a kick-off call, or even midstream in a project, that key resources on the hospital side are having to focus on some other project work and will therefore need to get back with us "in a few weeks." We can certainly see and understand the pressures you are dealing with inside the hospital. At the same time, we have witnessed an amazing amount of dedication from our customers. I know of several personal stories where an individual was working very long hours during the day and again at night while connected to the hospital VPN. They were doing this while caring for family members or friends
Transcript of Meaningful Use - Delivery Update · Challenges Message from Senior Management Call 978.539.0734...
Message fromSenior Management
Meaningful Use - Delivery Update
Jeff McGeathSenior Vice President
Surfing the Patient-Generated Health DataTsunami
Ensure Meaningful UseReadiness Amidst
Approaching Deadlines
Warren GeneralOvercomes ITImplementationChallenges
Message fromSenior Management
Call 978.539.0734
Meaningful Use - Delivery UpdateJeff McGeath, Sr. VP of Software Solutions
I’ve heard, and I believe, that the time in which we find ourselves in at this verymoment is the most stressful period in the history of Healthcare IT. Hospitaladministrators, clinical leaders, IT management, and all of the analysts whoperform various duties inside the hospital have been extremely taxed. We see itat almost every customer site where we engage in delivering our solutions. Ithas not been an uncommon occurrence for us to hear on a kick-off call, or evenmidstream in a project, that key resources on the hospital side are having tofocus on some other project work and will therefore need to get back with us "ina few weeks." We can certainly see and understand the pressures you aredealing with inside the hospital.
At the same time, we have witnessed an amazing amount of dedication from ourcustomers. I know of several personal stories where an individual was workingvery long hours during the day and again at night while connected to thehospital VPN. They were doing this while caring for family members or friends
Call 978.539.0734 or [email protected] 24/7, 365 days ayear.
hospital VPN. They were doing this while caring for family members or friendswho were sick and battling health issues. Everyone we have the opportunity towork with has been laser focused on Meaningful Use projects and getting themdelivered. Even with all the distractions, be they personal, or internal, or vendor-related, we continue to see customers implementing their projects. The peoplewe call our peers, the people who have elected to make a career in Healthcareare a resilient bunch.
At Iatric Systems, we are encouraged by how our industry is handling thepressure-packed times that are unfolding before our eyes. The lessons we arelearning during these stressful times are setting up our industry for fantasticgrowth. Coinciding with the fact that hospitals are using more technology thanever before, we as an industry are getting better at delivering technology,managing multiple projects, dealing with resource constraints, and applying newtechnology advances into our patient care workflows. So we are encouragedbecause you have succeeded at implementing many new technologies; Patientportals, CPOE systems, quality measure systems, auditing systems, engagementtechnologies, etc. Now the question becomes, what are you going to do toREALLY leverage all the systems in order to achieve positive bottom line results,and how will you ensure those systems are able to communicate with eachother?
We would like to help. Over the last 24 years, we have built our company on thefoundation of helping hospitals leverage their investments. Integration is ourDNA, and we understand all of the solutions you have put in place, because wehave product solutions in most every category of MU2 solution offerings. As anexample, even if you didn’t deploy a patient portal from Iatric Systems, you canrest assured we know the space well and we can assist you in getting yourpatient portal integrated and communicating effectively in order to achieve thosebottom line results.
The month of June was a whirlwind of activity for you and for us - a monthfocused on Meaningful Use solutions as a top priority. Those key deliveries are aresult of hospitals and Iatric Systems collaborating and coming together in veryhard work, long hours, and levels of dedication that have been outstanding towitness. I know there is more hard work to come and look forward to workingside-by-side with you to meet your integration needs.
Surfing the Patient-Generated Health DataTsunamiMark Johnson, RN-BC, HMA, CPHIMSAccount Executive
A 2013 survey, "Intel Healthcare Innovation Barometer," indicated that70% of the respondents would share information from a "smart toilet," and morethan 80% would share health information if it would lower their medical costs.Patients are ready and willing to send massive amounts of information toproviders from wearable technologies to "smart toilets," creating increasedanxiety and a feeling of futility among providers, who are sensing a datatsunami heading towards the health care shores in America.
Early indicators of Meaningful Use Stage 3 objectives show a push toward moreopen solicitation and structured methodology for accepting more informationfrom patients and family members into clinical record systems. How canproviders collaboratively surf these waves of data in a way that is safe,transparent, and leads to gains in improving the patient experience, improvingthe health of populations, and lowering health care costs?
Patient-Generated Health Data (PGHD) has been defined as health-relateddata created, recorded, or gathered by patients (and family members andcaregivers) to address a health concern. PGHD is any health data not captured in
a clinical setting by a provider. PGHD can be anything from a glucometer readingrecorded in a notebook to an emotional mood rating captured on a smartphoneapp. However, currently most of the information gathered is not shared withproviders effectively and consistently. Providers should not think of PGHD as afad. In fact, most market experts predict leaders — such as Apple, Samsung,and Google — will continue to push innovation and adoption of PGHD devices forconsumers, thus rapidly moving PGHD further into the mainstream. That meansmore PGHD will be collected than ever before!
Read more about the tsunami of PGHD ahead in my HIMSS blog article, andshare your thoughts and experiences.
Ensure Meaningful Use Readiness Amidst
Approaching DeadlinesThe deadlines for Meaningful Use Stage 2 are approaching fast, and the fact thatthe majority of hospitals and eligible providers have not yet attested is cause forsome concern. Regardless of where you are in the process of attesting forMeaningful Use, you probably still have questions around implementation andtracking of specific measures. You might be wondering if there’s a gap in yourMeaningful Use or patient engagement plan, or working to pull togetherdocumentation to prepare for a potential audit.
To help hospitals and eligible providers navigate the changing landscape ofMeaningful Use, we’re offering a demonstration webcast July 29th and August7th at 2:00 pm ET.
This session will provide valuable Meaningful Use information including:
Recent updates from CMSKeys to audit preparationHow to simplify the calculations, tracking, and reporting of MeaningfulUse measures and Clinical Quality MeasuresHow to identify and correct gaps in your Meaningful Use planHow to ensure that IMO terminology mapping is completed accuratelyand on-time
Register for either 1-hour webcast on July 29 or August 7, provided by ourIatric Systems Meaningful Use experts.
Warren General Overcomes IT ImplementationChallengesWarren General Hospital faced an incredibly tight timeline to meet grantrequirements for integration using Direct. The timeline was so tight, in fact, thatmany people involved thought it couldn’t be done.
Read Warren General’s full story now to learn how they were able toovercome significant integration challenges to meet the grant requirements.With the help of the Iatric Systems Professional Services team, Warren Generalfound the support, expertise, and resources to relieve their over-burdened ITstaff and achieve their goals.
Compliance CornerKay Jackson, Manager, Software Certification, and Compliance
CQMs for 2014
This month I want to recap some information about 2014 Clinical QualityMeasures (CQMs). First, remember every Eligible Hospital (EH), Critical AccessHospital (CAH), or Eligible Provider (EP) must attest in 2014 using the 2014CQMs, regardless of the Stage of Meaningful Use.
For CMS FY 2014, hospitals are required to attest to 16 total CQMs; the selectedCQMs must cover at least three of the National Quality Strategy domains. Sochoose your CQMs to track for 2014 wisely, and look for CQMs that match yourpatient population. For our CQM dashboard customers, we provide a full-timeRegistered Nurse to assist with this selection. We have also created 2014 CQMreference sheets for each CQM to support our customers in the best selection.While CMS first stated in 2012 that EH or CAH could not report on any CQMsthat scored a zero, they now allow you to report zeroes. My recommendation,however, is to limit the zeroes and consider tracking more than the requiredCQMs for your EH, CAH or EP. That way you have extras to report the bestrequired CQMs.
Second, CMS initially stated that any EH and CAH past Stage 1 Year 1 in 2014must attest electronically. That has since been changed from QRDA Cat 3 toQRDA Cat 1 electronic reporting, and CMS recommends you attest manually withyour Core and Menu measures for 2014. Bottom line was they were not readyfor electronic submission, nor did they give vendors time to change the QRDAreporting change.
What is the difference between QRDA Cat 3 and QRDA Cat 1? Well, a lot! QRDACat 3 was aggregate level data so one big file with all the info combined. QRDACat 1 is patient level data; each patient contained in a CQM will have their ownseparate file with many data elements about that patient. So if for yourreporting period you have 800 patients total in all your CQMs, the QRDA Cat 1upload will contain 800 files. Therefore the upload process may take a while, andany failures will need to be resolved.
Whether CMS and QualityNet will be ready for QRDA Cat 1 in 2015 remains to beseen, and you may be reporting quarterly or yearly. But be aware that in orderto secure your Medicare ID numbers for 2014 attestation via the CHPL, thevendor preparing your CQMs for attestation must be certified for QRDA Cat 1and Cat 3.
Third, what happens if the NPRM is passed? Will your team decide to revertback to the 2013 CQMs for 2014 reporting? CMS has stated that the results willbe published around September 1, 2014. I have recommended to our customersto arrive at a Plan B while moving full steam ahead with 2014 reporting. CMSreleased a CEHRT NPRM Decision Tool on July 7th that can walk you through theproposed regulation and find out what is best under the rule for your site. Go tohttp://go.cms.gov/1jRHwcg and follow the steps.
Finally, there are two CMS sponsored sites I recommend. The first is the 2014Clinical Quality Measures Tipsheet located at: http://go.cms.gov/1mY8R1M.The second recommended website is JIRA - join it to follow questions, answers,and exchange of ideas. Our team has also found thehttp://oncprojectracking.org/ website very helpful.
Report Writing TipsJoe Cocuzzo, Senior Vice President – Report Writing Services
This month we have a tip for NPR fans (MAGIC or Client/Server) and a SQL tipwritten by Thomas Harlan.
NPR Tip (MAGIC or Client/Server) – When Standard Graphics AttributesFall Short
One limitation of NPR report graphical attributes is that you can only startvertical lines at the top of a box. Here is an example of a page header for adischarge order form:
Many preprinted forms have slightly different graphics for a page header, lookinglike this, leaving a space in the upper right for an “address-o-graph” stamping:
How could we reproduce this on an NPR report?
You can produce a vertical line, horizontal line, or grey or white box anywhere onthe page in a C/S or MAGIC NPR report by using the utility Z.graphics, which hasthe following arguments:
Arguments: A = Box type 0 - black border 1 - grey box 2 - grey box and black border B = length of box C = ht of box (DFT=1) (can be 0 for just a horizontal line) D = number of chars to move right (+) or left (-) before starting box E = number of chars to move down (+) or (-) before starting box. F = gray scale (default = 10%) G = width of lines (DFT=5)
So if we remove the BX command from the page header of the report, and usethe HL= (horizontal line) command to draw a line across the bottom of the pageheader, we can just add a call to Z.graphics to draw the vertical line down fromthe top of the page to the vertical line:
Let’s review how we are using the Z.graphics command. To draw our box, wepass the following arguments:
A = 0, this means we want a black border boxB = 0, length of box is zero which means we are drawing a vertical line.C = 6, make the box 6 lines high (decimals are accepted as values)D = 65 move to the right 65 spaces before starting the “box” (really a line here)E = 0-5.5 We need to move up 5.5 lines so we subtract 5.5 from zero for the “move up”argument. We could also pass “-5.5” as the E argument.F = not relevant, no grey shadingG = width of line (0-9 accepted)
(Note that to draw horizontal lines, you pass a non-zero length and a zeroheight).
We could also use an LC attribute to hold our Z.graphics code:
A LC expression becomes the condition of an IF statement that is wrappedaround the line. So if you use an LC for other purposes, you need to decide ifyou need your line to print or be suppressed. To control what happens, add a nilor a value at the end of your LC expression, and that will control the value of theIF condition and will control whether the line prints.
FINAL IMPORTANT POINT:If you have Boxes anywhere on your report, MEDITECH will automatically createa box around the entire page, so unless I add a special footnote to this report, Iwill still get this:
To prevent the default boxing add the following footnote to your report. (Thisfootnote also will suppress the boxing of the standard page banner if your reporthas one).
Once we have done this, the automatic boxing of the page no longer occurs:
SQL Tip - Find Queries, Document Sections and Interventions(MEDITECH 6.x Only)
A report request arrives on your desk – complete with screenshots of screensfrom MEDITECH complete with circles and arrows. But the fields are unfamiliar…a query to the requestor for a Shift-F9 and screenshot of the resulting pop-upyields nothing. “Ah,” you think, “custom queries on a CDS, document section orintervention. Why oh why didn’t MEDITECH code Shift-F9 so it would tell us whatquery mnemonic was in play? Why?”
But fear not, thanks to the DR xfer process also covering dictionaries, you canuse SQL to query the build of screens, assessments, and interventions. Attachedto this tip is a stored procedure that searches the dictionaries for usage ofqueries and lets you know not only which screens they are used on, but whichcollector tables contain the responses!
As with all of our example SQL code, you will need to run the script against yourDR to compile a named query (or stored procedure) that you can then call with asimple SQL command like:
EXEC zcus.dbo.MIS_zcus_iatric_find_query_config 'CAN.OX' -- Query mnemonic to search for orALL ,'ALL' -- Query text to search for or ALL ,'ALL' -- Document Section Mnemonic or ALL ,'ALL' -- Document Section text or ALL ,'ALL' -- Intervention Mnemonic or ALL ,'ALL' -- Intervention text to search for or ALL ,'N' -- Show Row Counts from storage locations
Note that each parameter drives a LIKE predicate in the code, so you cansearch for partial strings (or use wildcards like % and _).
Also note that you can mix the fields, using some or all of them.
Those screen shots you got? With the circles and arrows? Use the text labelsfrom the fields to search by Query Text and you will find what you’re looking for.
In this example our search finds us five records:
QueryID
QueryText
QueryType
GroupResponseID
MIS DocSect ID
MIS Doc SectName
Pcs InterventionID
PcsInterventionName
CAN.OX O2DeliveryMethod
Group CAN.OX RAD.D/C Radiology D/Cdocumentation
(None) (None)
CAN.OX O2DeliveryMethod
Group CAN.OX GEN.CANCERCancer CenterDocumentation
CANCER.CENTER Cancer CenterDocumentation
CAN.OX O2DeliveryMethod
Group CAN.OX GEN.CANCERCancer CenterDocumentation
RN.CANCERCENTERDocumentationfor AmbulatoryServices
CAN.OX O2DeliveryMethod
Group CAN.OX GEN.RADRN Radiology RNDocumentation
RN.RAD Radiology RNDocumentation
CAN.OX O2 Group CAN.OX RAD.DC Radiology D/C RN.RAD Radiology RN
DeliveryMethod
documentation Documentation
Here we see that the CAN.OX query can be find on four different documentsections in three different interventions – or as a standalone.
Particularly when you are trying to retrieve PCS assessment query data, yourspeediest way to get at the response is to first identify potential visits, thensearch those visit’s interventions, then document sections and then finally thequery/response data. Knowing which interventions and document sections holdthe queries you are looking for will speed up that process enormously.
A Warning Note: But wait, you say, what about RegAcctQuery_Result?Doesn’t it hold all of the PCS query responses? Isn’t it designed to be reportedagainst so you don’t have to plunge into the hellish complexity of the PCStables?
Yes, but… a query needs to have its AccountQuery flag set to Y before theresponses will flow over to RegAcctQuery_Result and the background job thatpopulates the table from the PCS tables needs to be working flawlessly.
Unfortunately, for the data that you need for this latest report… that probablywon’t be true. So back to the PCS mines for you!
Bonus! Attached to this tip, in addition to the SQL code, is a MicrosoftReporting Services report to package it up all pretty-like and make it easy todistribute to your analysts.
Extra Credit: When you examine the code, you’ll find that the @cRowCountYNparameter does not search every single possible response storage location. Addsome more! Particularly if you know there are custom screens attached tomodules like MM or BAR at your organization.
Visit our report library athttp://www.iatric.com/Information/NPRReportLibrarySearch.aspx tolook them up.
You can find additional Report Writing Tips on our website athttp://www.iatric.com/Information/NPRTips.aspx, as well as informationabout our on-site Report Writer Training and Report Writing Services.
Read Joe’s blog posts at MEDI-Talk.
To subscribe for email notifications for new Report Writing classes, please followthis link:http://www.iatric.com/Information/Classes.aspx.
For more information, please contact Karen Roemer at 978.805.3142 or [email protected].
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