EMR-LINK A Fall 2010 Review. Housekeeping 1.Shrinking the GTM session 2.Being muted. Your Audio Pin Raising hands. 3.Well have breaks for questions. 4.Use

EMR-LINK

A Fall 2010 Review

Housekeeping

1. Shrinking the GTM session2. Being muted.

• Your Audio Pin• Raising hands.

3. We’ll have breaks for questions.4. Use “Chat” to queue up

questions.

What We’ll Cover Today What’s new with orders?

• Auto-splitting

• Courtesy copies

• Billing interface

• EMR-Link 2.0 (well, it’s not so new any longer)

What’s new with results?• Always copy this user…..

• Send results to my HIE too….

New products• PDF download

• HIE Connect

• Adding a second lab (and the three possible levels)

• Adding radiology orders

Maintenance tips• When your lab changes an order code

• Where to find help

Clinic’s EMR-LINK Account

Services

The Whole PictureLab

Clinic’s EMR

Lin

kLog

ic

• Order Entry Questions• Requisition printing• ABN printing• Label printing

Radiology

Meds

LabRequisitioning

Database

• Rules-based routing (insurance and location)

• Clinic specific mappingof EMR-to-Lab data

• Point-of-care ABN Validation(Uses lab’s ABN rules)

• Manifest Reports• Future Orders• Billing interface back to

PM (future)

• Auto-Completion• Provider desktop

notification

Clinic’s mapping tables Requisition Completion

LIS

ABN Validation

• HL7 compliant ORM• Complete order

information to lab’s requirements



Electronic (HL7) ResultLab Result Manager

• Secure HTTPSdownloads

4

3

22

8

7EMR-Link Connector

EMR data Lab 1 Data Lab 2 Data

Provider Names UPIN/NPI

Order codes Lab order codes Lab order codes

Insurance Lab Insurance Lab Insurance

Location of Care Lab account # Lab account #

Routing Rules (choose the lab)

5

Your Code EMR Order Codes

1

Lab 2Lab 1

Lab compendiums

3

HL7 Order

6

Req

Label


Services

The Billing InterfaceLab

Clinic’s EMR

Lin

kLog

ic


Radiology

Meds

LabRequisitioning

Database




• Manifest Reports• Future Orders• Billing interface back to

PM (future)

• Auto-Completion• Provider desktop

notification


LIS

ABN Validation





Electronic (HL7) ResultLab Result Manager

EMR-Link Connector







Your Code EMR Order Codes

1

Lab 2Lab 1

Lab compendiums

3

HL7 Order

Req

Label

2

PMIS

4

Lab

EMR-LINK

Services

Consolidation For The Practice

Clinic’s EMR

LinkLo

gic

Radiology

Meds

Lab OrdersDatabase

Lab OrdersDatabase

Clinic’s mapping tables Order Completion

Electronic (HL7) Results


EMR-Link ConnectorEMR-Link Connector

Lab Result Manager

Electronic (HL7) Order

Lab

Your EMR Order Codes

EMR Lab1 Lab2 Lab3

Provider s UPIN / NPI / EMRLogin

Order codes Tests Tests Tests

Insurance Insurance Insurance Insurance

Location Acct # Acct # Acct #


ABN ValidationABN

ValidationABN Validation

EMR-Link: Extensible Lab and EMR Connectivity

EMR-Link

Repositories(HIE or public)

Reference Labs

HospitalLabs

ImagingDepts

EMR Clinic 1

EMR Clinic 2

EMR Clinic 3

Labs with Bi-Directional

Integration• LabCorp• Quest• Bio-Reference• CPL (Sonic)• Mullins• Providence• PAML• PeaceHealth• Mercy Medical• Cortland



EMR-to-Hospital Integration

Orders

HospitalPractice

ECGPACS

Lab

Structured results

URL link to image

Link to reporting system

Full text report

LinkLo

gic

En

gin

e

Orders hospitalservices

Results review

•Lab results•ECG reports/images•Radiology results/images

Hospital Benefits• Competitive Outreach Services • Increase Referrals to Departmental

Services. • Clean orders (decreases write-offs)

Hospital Benefits• Competitive Outreach Services • Increase Referrals to Departmental

Services. • Clean orders (decreases write-offs)

Practice Benefits• Order reconciliation (auto-

completion)• Guaranteed chart matching• Link to images (radiology)

Practice Benefits• Order reconciliation (auto-

completion)• Guaranteed chart matching• Link to images (radiology)

EMR-Link

ImagingClinic

Radiology Workflow Improvements

Order Completion

RIS

EMR Chart Matching

Physician Review

Physician Ordering

• Results match to charts

• Desktop notification• Updates the order

status

•Easy to order•ABN validated

• Pre-auth?• Scheduling?• Clinical lists

• AOE questions• Minimize data entry

PACS

• Contains link to the image study

• Req’d insurance• Verified ABN• No data entry

PDF Result Interfaces

•The lab report you already know now includes a link that references the PDF•Enhanced view can include color, graphics, etc. Ideal for specialty labs•You can add multiple PDF storage locations as needed. E.g., if you fill up one disk you can

leave the current PDF files there and start a new data store elsewhere.•Easy to install and configure. It only takes a few minutes more than a standard results kit.•PDF storage is at the clinic so you have ownership of the data•Works with all supported EMR releases except 5.6.


Services

PDF Results FlowLab

Clinic’s EMR

Lin

kLog

ic


Radiology

Meds

LabRequisitioning

Database





LIS

ABN Validation





Electronic (HL7) ResultWith PDF

Lab Result Manager3







PDF FileStore

1

Lab 2Lab 1

Lab compendiums

HL7 Order

2

Your EMR Order Codes

Link to PDF

4

Health Information ExchangesHealth information exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system.

Health Information Exchanges

Health Information Exchanges

EMR-Link: Extensible Lab and EMR Connectivity

EMR-Link

Repositories(HIE or public)

Reference Labs

HospitalLabs

ImagingDepts

EMR Clinic 1

EMR Clinic 2

EMR Clinic 3





Alliance of Chicago deploys EMRs at community health centers across the US

They’ve standardized on Ignis for all lab and imaging integration. They’ve seen improvements here……..

Implementation Times Improve

Setup and Test Previous Time Req’d

Time with Ignis Tools

Load Test Library 80 hours 4 hours

Dr’s Custom Lists 24 hours 8 hours

Panels 16 hours 4 hours

From 120 hours

… to 16 hours

EMROrders Builder

Automating The Setup: The Orders Builder

EMRLab Utilization Reports

Orders Builder EMR Clinical Kits

Builds your order categories(or maps the ones you already have)

Builds your custom order lists

The Lab Results Builder

Builds your EMR flow-sheet

Builds your cross reference (xref) from lab codes to EMR flow-sheet observation terms(or evaluates the one you have already)

Questions and

Discussion

In Closing Provider and practice workflow is job 1 We automate setup We automate maintenance We’ll keep you up to date (monthly release notes) We give you tools for your job (ROI worksheet) Contact us any time

www.emr-link.com

http://www.emr-link.com/

Thank You!

Pat Wolfram

Services

Results Only DataflowLab

Clinic’s EMR

LinkLo

gic

Radiology

Meds

Lab Order Codes

LIS

Paper Lab Order

Lab Results

Electronic (HL7) ResultResult Manager

Result Manager


Clinic’s EMRLINK Account

• Uniform and Secure Download Mechanism for the Clinic

• Download method for one lab or many labs

• Uniform Distribution Mechanism for Labs

• Establishes EMR-Link framework for adding Lab Orders.

• Queues results for the clinic• Responds to HTTPS requests for

downloads.

Comparing Lab Orders….

Centricity EMR 9.2And

EMR-Link

Services

The Benefits of Centricity 9.2HL7 ORM and assisted order completion.

Lab

Clinic’s EMR

LinkL

ogic

Radiology

Meds

Lab Order Codes

LIS

Lab Orders

Lab Results

• HL7 compliant ORM

• Patient ID • Provider ID



1. ORM complies with the HL7 ORM orders message needed by the labs.

2. Patient ID in the order guarantees a match to the patient’s chart when the result is returned.

3. Narrows the choices of orders for manual “complete”

Services

EMR-Link adds the following to 9.2Lab

Clinic’s EMR

LinkL

ogic

Radiology

Meds

Lab Order Codes

LIS Lab Results

Order completion

EMR data Lab Data


Order codes Lab order codes

Insurance Lab Insurance

Location of Care Lab account #

ABN Validation

Lab Orders

Ordersdatabase

Ordersdatabase





Clinic’s mapping tables

• Billing decisions are made.

• Test specific (AOE) Order Entry Questions

• Requisition printing• ABN printing• Label printing

• Billing decisions are made.

• Test specific (AOE) Order Entry Questions

• Requisition printing• ABN printing• Label printing







• Manifest Reports• Future Orders• Billing messages sent

to clinic’s PM.

• Manifest Reports• Future Orders• Billing messages sent

to clinic’s PM.

• Auto-Completion• Dr. Desktop Notification• Auto-Completion• Dr. Desktop Notification

42

6

5

3

1

The Difference…… with EMR-Link you get 9.2 ORM support and.

1. Point of care ABN validation. EMR-Link informs the provider at the point of care that a lab test is medically necessary based on CRM (Medicare)’s ABN rules.

2. Rules based routing. EMR-Link routes your lab tests to the appropriate lab service provider, based on the patient’s insurance and your location of care preferences.

3. Support for UPIN or NPI. The provider’s UPIN or NPI number is inserted into the order. Also, once the lab is chosen, EMR-Link inserts the correct order codes for that lab, the correct insurance codes, and the account number for that lab.

4. Requisition completion --- with minimal manual entry of order data. • No manual entry of data by your nurse or phlebotomist.

• Insurance rules decide if billing is to the 3rd party (insurance company), client (bill to the clinic), or to the patient.

• Required test specific AOE (ask at order entry) questions are asked

• Requisitions to the lab’s specifications are printed

• Labels are printed for specimen containers

• ABNs, when needed, are printed.

5. Manifest Reporting: The EMR-Link lab orders database provides

• Downloadable manifest reporting includes: patient, test ordered, chosen lab, billing type chosen, insurance, Patient Service Center orders, ….etc.

• Future orders are stored here until the patient returns for the specimen collection, triggering the “Order Completion” process.

• HL7 billing messages are returned to the practices PM based on insurance or lab chosen.

6. Auto-Completion of Orders. Returned lab results are processed with the initial lab orders information.

• EMR test IDs are inserted into the ORU result, enabling Centricity EMR’s “auto-completion” machinery. Upon signing of the result, the specific tests will auto-complete.

• The ordering provider’s UPIN (or NPI) is converted to their EMR login. This ensures desktop notification to the ordering provider.

Data Flow for PDF DownloadsLabEMR-LINKCentricity EMR

LinkLo

gic

Patient’s Chart

Provider’s Desktop

HTTPS

Electronic (HL7) Order

EMR-LinkDatabase

EMR-LinkDatabase

Result Manager:

• Receive lab result and encoded PDF

• Insert original EMR order ID

• Insert ordering provider

• Send PDF to Clinic file store

• Send ORU to EMR

• Send MDM to EMR

Result Manager:

• Receive lab result and encoded PDF

• Insert original EMR order ID

• Insert ordering provider

• Send PDF to Clinic file store

• Send ORU to EMR

• Send MDM to EMR

ORU Message

MDM MessageWith PDF Reference

Clinic’s PDF File store

ABN Validation

Electronic (HL7) Result

With embedded PDF

PDF File

Documents

EMR-LINK A Fall 2010 Review. Housekeeping 1.Shrinking the GTM session 2.Being muted. Your Audio Pin Raising hands. 3.Well have breaks for questions. 4.Use