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4/15/2016
1
New Advances in ECM:
Dan Stober
How content management is transforming HIM practices
Dan StoberSolution Consultant
Recall
O EMR d b h
Healthcare IT Challenges
• One EMR was supposed to be enough• Is everything really in the EMR?
• What makes up the complete legal record?
• We have all of these complex processes that aren’t addressed in the EMR
l l• Clinical• Non‐clinical
• I.T. resources are limited• Multiple vendors
• Multiple system administrators
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Hi i l
Old Way of Doing Things
HIM Content Challenges
• Historical• Paper Volume
• Physical Chart Management
• Photos• Fetal Monitor Strips
L Sh t• Loose Sheets
C
HIM Content Challenges
• Current• EMR/EHR Content
• Disparate Systems
• Images
• “‐ologies”R l f I f ti• Release of Information
• Information Governance – HIM at the table?
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Behavioral Health+ Scheduling+
Clinical Care+
M di l I i
Accounts Payable+
Patient Accounting+
Pharmacy+Physician Office+
Revenue Cycle+
Legal+
Human Resources+Admitting/Patient Patient Access+
Medical Imaging+
Home Health/Hospice+Health Information Management+Audits+
Monthly Close+
To become paperless, an organization must o beco e pape ess, a o ga at o uststop creating new paper, digitize incoming paper at the beginning of a process, and digitize any required old paper.
Robert GeschkeHyland Software
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Centro Cirúrgico 1935 Slide do Dr.Ed Hammond
Centro Cirúrgico 2015Slide do Dr.Ed Hammond
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Stop Creating Paper
What Content is Missing from the Record?
Specialty Areas
Anesthesiology Cardiology Dermatology
Examples of Commonly Required Content
Angiogram Operative Reports CT Scan ED Endocrinology Family Medicine Gastroenterology Hematology ICU Nephrology Neurology Nuclear Med Obstetrics Oncology h h l l
EKG Fetal Strips Holter Monitoring Reports
MRI Renal Scan Digital Path Images Pathology ReportsMole Mapping Wound ImagesPET PT Videos Glucometer
Ophthalmology Oral Surgery Pathology Pediatrics Pulmonology Radiology Rehabilitative Medicine Rheumatology/Immunology Surgery Urology
readings
PFTs Fluoroscopy CV Cath Procedure Reports SPECT
U/S Mammogram Consults
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GAME CHANGER
New Technologies
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Paperless Registration/Access on a Tablet
Key Features Benefits• Configure sets of forms for • Eliminate the need for patients• Configure sets of forms for patients by visit type and facilityE‐forms
• Defined form lifespan support
• Supports multiple languages
• Flexibility to support multiple
• Eliminate the need for patients to fill out information that’s already known, such as name, DOB and address
• Eliminate the need for patients to complete forms already on file
• Flexibility to support multiple platforms
• Android vs. iOS
• Patients visiting other clinical areas will not be asked to fill out the same forms that were completed minutes earlier
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Improve Patient Access
• Eliminate scanning and indexing
• Increase Patient Access efficiency
• Forms linked through HL7 messages to the Electronic Patient Record (EPR/EMR)
• Information collected at the point of access is available immediately across the hospital
• Resolve form redundancy for patients
What to consider?
•What is your current Patient Access process?
•How many Patient Access forms do you have?
• Line of Patients at Patient Access Desk•How often is care delayed due to lack of signed consent forms?
•Numerous clipboards/form files
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Upload Wound Pictures to EMRMobile Wound Capture
Benefits• Resolves lack of consistent image
storage locations• Allows Comparison of images
Key Features
• Phones, Tablets, etc.
• Instantly upload images to patient record
• Automatically indexed
• Virtual real‐time access to images
• Allows Comparison of images
• Indexed directly to the patient
• All image formats supported
• Provides a complete picture for Patient Care
• Help clinical staff (pre vs post‐op, inpatient, outpatient and home care)
• Leverage Health Systems' mobile device investments
• Can use any mobile device to upload images
• Images don’t reside on the device
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H i d h ?
What to Consider?
• How are you capturing wound photos? • Cameras, phones, tablets
• Are these images loaded into the EMR?
• What departments are capturing this type of content?
• Can HIM access the images?Can HIM access the images?
• Can clinicians easily access the images?
• Hyperbaric Chamber, Diabetic Centers, ED/Trauma
C S A I
Universal Scope Capture• Capture, Store, Annotate Images
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Benefits• Images stored directly into patient chart/encounter
Key Features• Images stored directly into patient chart/encounter chart/encounter
• Images viewable within the Electronic Patient Record immediately
• Clinicians can digitally annotate on images without permanent alteration
• Images become part of the medical d
chart/encounter
• Improved clinical experience
• Save cost on printing of thermals
• Workflow maintains the same between scopes
• Scope Vendor and Specialty agnostic record
• Location to store outlier images
• Viewable within EMR through specialized viewers
p p y g
• No longer needing to print and store images
What to Consider?
Wh t tl d i ith i l i ?• What are you currently doing with your surgical scope images?
• How are the thermals/images currently being stored? Paper? Electronically?
• Are you able to store all clinical specialties or only select groups?• Multispecialty Surgical Groups
• GI Orthopaedics Cardiology OB/GYN• GI, Orthopaedics, Cardiology, OB/GYN
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Clinical Viewers & Enterprise Integration
Benefits• View relevant documents alongside images
Key Features• Quickly navigate to the right information images
• Access necessary information from within the EMR
• Universal access to clinical content and images from all specialties
• Improve processes and create ffi i i
information
• Everything pulled together in one are• DICOM and Non‐DICOM
• Timeline view
• Transforms the clinicians experience
• Configurable Tabsefficiencies
• Documents/Images shown in thumbnails
• Color, personal, new
• Side‐by‐Side Viewing
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Capture and Organize
& FilteringConfigurable Tabs
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New Content ViewNew Content View
Personal Tabs & Thumbnail ViewPersonal Tabs & Thumbnail View
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Case Container:Case Container:Case Container: Case Container:
UserUser‐‐created created tabs tabs
Specific to Clinician Specific to Clinician and Patientand Patient
DICOM Access
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Side‐by‐Side Viewing
All content: DICOM and non‐DICOM images
Timeline Timeline Viewing:Viewing:
•• View content View content (episodes) across (episodes) across continuumcontinuum
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What to Consider?
I ll li i l i f ti d i i bl ithi EMR?• Is all your clinical information and images viewable within your EMR?
• Are clinicians currently accessing multiple PACS?
• Do your physicians need to open another screen to view PACS/DICOM Images?
• Is there an initiative to have physicians stay within the EMR?
• Multi‐Screen Set‐up in Reading Rooms• Multi‐Screen Set‐up in Reading Rooms
Vendor Neutral Archive (VNA)
DICOM and Non‐DICOM in one place
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VNAVendor Neutral Archive
Benefits• Access to Patient Information in EMR
• CT X Rays MRIs
Key Features• Eliminate the Multi‐Silo Storage Approach • CT, X‐Rays, MRIs
• Access images with Diagnostic Viewing Quality
• All documents become part or DM and Back‐up Processes
• Management of all documents in one l ti
Approach• Cut down on PACS Storage
• Store both DICOM and Non‐DICOM
• Can leverage current investment in OnBase
• Cut down on PACS Storage and Costslocation
• Easily access from the Patient or encounter level
• Reduce resources to manage Imaging systems
• Increase sustainability and governance of the archive process
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Release of Information
List of Requests
Group by columns
Sort by columnsFilter by text
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RequestLookups prevent the need to type information
Pricing Policies and tiered pricing support
multiple pricing structures
Supports all delivery methods including electronic
Account for items outside of OnBase
Easily Add Documents
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Automatically Generate and Print Invoices
Customize with your letterhead
Merges all required contact
Automatically creates and populates tables
of information
contact information
THANK YOU