Archive for Custom Reports

Eagles Landing Family Practice Case Study

The Client
Eagles Landing Family Practice features 11 locations and 45 care providers serving families in the Atlanta metropolitan area. It is the largest independent health care company of primary care providers in the state of Georgia, and is known for its keen focus on increasing the quality of care and enhancing efficiencies through innovative use of their eClinicalWorks electronic health records and practice management system.

The Situation
Primary Care practices and physician groups find themselves in a challenging segment of health care. These groups typically serve as the “home base” for a patient’s overall health and wellbeing, while governmental programs such as MIPS, MACRA and PCMH require them to engage in increased data collection and reporting – functions that don’t provide revenue to the practice or its providers. The key to thriving in this environment is determining how to best leverage electronic health records and practice management systems, build technology to interface with these systems, and develop workflows that will increase efficiency while improving care and communication.

The Client’s Need
Eagles finds itself in the midst of rapid, yet deliberate growth, and recognized the need to put systems in place to better manage population health and improve the way the practices communicate with patients to ensure that care is delivered promptly, accurately, and consistently, and in a way that delivers value to both patients and the practice itself. A high level of automation and customization was required to achieve this goal, and it was quickly determined that Eagles’ needs and vision were quite different from how a typical practice uses eClinicalWorks. In fact, they were originally told what they were trying to do wasn’t possible. That’s when they turned to Mi7 for help.

How Mi7 Solutions Helped
The Eagles vision for how they wanted to leverage their eClinicalWorks system to grow their practice and do business in a smarter way was quite advanced and involved a variety of different technology platforms. At a high level, the work Mi7 performed for Eagles included custom reporting, integration and automation of data with programs such as Salesforce and other third-party organizations and softwares. But it’s the details behind the purpose, functionality, and customization that make these projects so remarkable.

  • Data Integration – The Mi7 team integrated eClinicalWorks data into Salesforce to trigger patient communication and activity tracking to help ensure that patients were on track with appointments, testing, and other items critical to their overall care and health. In addition, this process integrates with the DASH scheduling system to allow for enhanced patient scheduling options.
  • Predictive Analytics – In order to initiate the various patient communication points, Mi7 developed processes within eClinicalWorks to calculate when those communications should happen and trigger the activity.
  • Custom Reporting – Eagles found that certain modules and registries, such as the CDSS section, were quite limited, and the process of creating custom registry alerts was not so straightforward. Mi7 created reporting that would address these needs, and produce the alerts and outcomes needed from the system.
  • Opportunity Capture Reports – Providing great health care involves ensuring patients are getting the tests and procedures they need. To accomplish this goal, Mi7 created opportunity capture reports to track whether patients were actually going in for routine tests such as mammograms or other health screenings, or one-time procedures they may need. Not only does this make for better overall care, it also makes good business sense in tracking captured and lost opportunities and putting systems into place to increase capture rates and track the associated revenue generated.
  • Automation – A primary goal for Eagles was to automate as much as possible, creating systems that would auto-populate data, flag issues, and generate alerts. One such automation revolves around PQRS reporting, in which codes are auto-inserted into the billing data. Mi7 also automated the process of payment posting within eClinicalWorks directly from their third-party patient payment portal. This eliminated the need for manual data entry and streamlined the process.

Results
Through the various projects implemented by Mi7, Eagles Landing Family Practice has been able to bring their vision to life in terms of leveraging eClinicalWorks to grow their practice – both organically through patient satisfaction, and financially through increased capture rates and more efficient processes. They’ve substantially increased their monthly billings across the practice and have been able to focus their staff on patient care and patient communication activities to better serve the population.

“We were told by others that our vision for what we wanted with our eClinicalWorks system wasn’t possible, but the Mi7 team made it happen. They have in-depth knowledge of eClinicalWorks, and team members who understand and embrace what we were striving to accomplish, not just with the system, but with our overall business, and they developed the solutions that actually worked for us. What Mi7 has created runs efficiently and has helped us reach our overall goals.”

Nick Williams
CEO, Eagles Landing Family Practice

Pump Up Your Jam (and your EHR Reporting)

A few weeks ago I finally got the motivation up to get our bikes ready to ride. The tires were completely flat. I started to pump up the tires with a little hand pump I have, but it takes several hundred pumps to inflate a tire to 55 lbs. I admit, I didn’t actually inflate the first tire all the way with the hand pump. After I had pumped 300 times and I only had about 20 lbs, I decided I needed some assistance. The next time I was at the department store with the name that means the same as “destination”, I took a look at their electric pumps. I reviewed all of the choices and decided on one that you plug into a wall outlet instead of a car 12V outlet. This will give us the most flexibility if we need to inflate a car tire, inflatable pool toys, etc.

I’m so excited to get the pump home so I can air up the tires and possibly go for a bike ride! I unpack the pump and look for the power cable. There is none. I read the box again. It doesn’t list any requirements. One line in the features section of the box says that it will connect to any extension cord. I guess this was the manufacturer’s way of saying that you need an extension cord to plug it in. I box it back up and put it on the shelf.

The next day I go to one of the big home improvement stores. I pick up an extension cord. The ends are connected together, but it looks like a three prong extension cord. When I get home, I take the pump out of the box, I unwrap the extension cord, unplug the ends… and it is a two prong extension cord! ARRRGGGHHH!

Well, I loathe going shopping, especially to the big home improvement stores, so I wait another day or two before going back to exchange the extension cord. When I do go back, I find the extension cords and unplug the ends to make sure that I get a three pronged extension cord this time.

Has this ever happened to you? I still maintain that the first problem with the pump was just clarity of packaging. How was I supposed to know that I needed an extension cord to plug something in? I confess to the second problem with the extension cord. I should have looked more closely to make sure I was getting what I needed. I didn’t realize that extension cords still came in two prong. My bad. In the end, I got the bike tires pumped up, but it took much longer to get it done with more than one trip to one of my favorite places on earth.

What’s the point? We see this regularly with clients and reports. Many clients are looking to analyze and use their data to better their business, but some have not committed to making the business changes to capture the data in a way that is usable for analysis. They just don’t have what they need to do the analysis.

We built a very complex quality report a while ago for a customer. This report had 15-20 quality metrics that were each dependent upon multiple pieces of data. You had to have this diagnosis group, have this lab, this Rx group, and data filled in the preventative medicine of the progress note for that day or in a note in the last 12 months. All of the quality metrics were that way. When we were scoping the report, we were very specific, with screen shots, about where the data will be captured, what specific data values we would count, and what the timeframe was for each metric. We set a timeframe that the providers had to complete their notes after the service date. We would then daily run the metrics for an appointment X days after the service date.

We went through testing. We modified some of the metrics. We did more testing. Then, when the client was satisfied, we installed the report on the users’ computers that needed it and told them to start running the report. Well, that would have been great…if what we were reporting was already how ALL of the providers were documenting. We had a call about once a week for the next couple of months researching issues with the report. All of them ended up not being the report, but the data that had been entered.

When you invest the time and money to come up with reports and other ways to analyze and make the best use of your data, you must make sure to educate the users to enter the data in the system in a way that you can analyze. You must insert controls that help you catch data entry or process issues. You can build the most awesome report or analytics in the world, but if you don’t have reliable data entry and a way to catch your data issues, the report is going to provide you incorrect results.

Admit it. You’re now ready to “Pump Up Your Jam” when it comes to your EMR reporting needs. And you probably have that song from the 90s running through your head too. You’re welcome. Mi7 is the pump to your jam, working with you to define the key metrics for your medical practice and come up with a way to track and report on that data. But it doesn’t end with the pump and the jam. Mi7 can also help you build the analytic reports to catch issues related to patient data, billing reports, efficiency and more to keep the business side of your practice on track.

Contact us today to discuss your EHR reporting needs.

Pass the Tofurkey and a Custom EHR Report

Well, I was going to write some witty story about using the right tool for the job, but, with all of the recent election talk, I figure we’ve had enough of that topic. So let’s get into the brisket (no not BREXIT!) ‐ meat, or Tofurkey if you prefer…

Reporting can be a challenging topic for anyone that uses, implements or supports reports. The key to understanding reports is to realize that any report you review is built for a specific person for a specific reason at a specific time. That person was trying to answer a specific question, so they built this report.

There are reports that have been developed to be used by the general user, but each general, or “canned”, report is still developed to answer a specific set of questions. This means that using a general report to answer questions for which the report was not designed may give you the wrong answer to the question you are trying to answer. This is why whenever someone is looking for a general report to answer a specific question, the question, business workflow, and variations to the question and workflow need to be reviewed to make sure that the right report is used to answer the specific question asked.

When I talk to different users about reports, I don’t start with an existing report. I always start with the question the user is trying to answer. I ask as many questions I can think of to try to understand what the user is trying to do. Many times I ask the same questions a different way to make sure that I completely understand.

I then get into the process. I look at the business process as a whole, including the system and non‐system parts of the process. Of course writing a custom ehr report from a system requires the data to be in the system, but you would be surprised to hear that many times the data the user wants to report is not currently captured in the system or it is captured in a way that is not reportable. It is only through understanding the business process as a whole that you can identify the restraints of report and the business process changes that might be necessary to properly answer the user’s question with a system report.

Once I understand the question and the process, I detail out the details of the report. There are five major categories of report details: logic, user selected filters, fields, report field to system mapping, field groupings, and report delivery.

Here are the various questions I ask, and items we consider when going through this process:

  • Logic ‐ Describe what conditions the data must meet in order to show or to be excluded from the report. For example, I only want patients with appointments in the selected timeframe that do not have a current, valid referral.
  • User Selected Filters ‐ List the filters that should be on a prompt page. In the example given above, you would have a “From Appointment Date” and a “To Appointment Date”. You might have an “Appointment Provider” filter if the user wanted to filter by appointment provider.
  • Fields – List the fields that the user wants on the report. For the example above, you might have the patient name, date of birth, appointment date, appointment time, appointment provider, and primary insurance.
  • Report Field to System Mapping ‐ List where each of the report fields listed above comes from the system. I find it beneficial to not only include the screen and field name in a table with the report field, but also include screen shots of the different fields.
  • Field Groupings ‐ Fields in the field list by which the user wants to group data on the report. This is typically for formatting, improving readability, or subtotals. In the example above, you might group by appointment provider or date.
  • Report Delivery ‐ It is important to understand what the user wants to do with the report. Do they want to download the data to CSV or Excel? Do they want a formatted report they can export to PDF and email? Do they want to automatically upload the data to a third party like an ACO, 340B vendor, or similar? Depending on the delivery method, you may need to change the tool you use to build the custom ehr report.

As you can see, there is a lot to consider when developing an ehr custom report. If you are looking at using a canned report, don’t just assume that because the title of a report sounds like what you are looking for that it is. Take a step back to look at what questions you are asking, what the business and system processes are, and then review the report to determine if it meets your needs.

Remember this Thanksgiving that sometimes homemade cranberry sauce may be what you think you want, but sometimes you just need a quality can of cranberry gelatin. Either way, give thanks for all your blessings, including the report developer that just completed the 20th revision of your report because you didn’t know what you really wanted when you started. I know they will be thankful for you!

Need a report, canned Spam for the holidays, or just not quite sure how to use all of the “ingredients” that make up your EHR system? Mi7 can mix it all up, cook it, and help you dish up a custom ehr report that your entire practice will enjoy. Want a custom ehr report that will help you better manage certain patient populations? Coming right up! Need to know the primary reasons your claims are being rejected, or where hang ups in the billing process might be? BAM! We can do that too.

Contact us today, we’d like to hear what questions you need answered.

Mi7 / CRMC Case Study – Report Interface

The Client
Capital Region Medical Center (CRMC) in Jefferson City, Mo. is an affiliate hospital of University of Missouri Health Care. It encompasses a full service hospital and an expansive clinic system covering eight counties. The hospital’s Inpatient Rehabilitation Center is one of the few accredited hospital-based rehabilitation centers in the state.

The Situation
For many years, CRMC had been using a manual, fax-based system to transfer diagnostic reports, or reports from various studies between 100+ providers across 30 clinics, using 23 separate EMR databases, in the region. In addition, reports between the hospital itself and the network of providers and clinics, including discharge orders, patient histories, and others, were being faxed and manually processed.

As the partner for the data migration project to create CRMC’s centralized eClinicalWorks system, Mi7 Solutions was well positioned to help them execute this phase of their eClinicalWorks project. Mi7’s experience with CRMC, their processes and needs, as well as their extensive knowledge of health care IT and eClinicalWorks made them a trusted resource.

The Client’s Need
Capital Regional Medical Center processes 400-800 reports each day between their 30 clinics and with the main hospital. The previous process was manual on both ends, meaning the sender and the receiver each had time consuming tasks to manage for hundreds of reports. With a recently implemented, centralized eClinicalWorks system in place, they sought a way to automate the process and make information more readily available.

It was also imperative that CRMC’s workflow was considered, as the process for how an automated reporting system functions would be much different from the way that the manual reports were flowing through their system. This involved both process documentation, as well as the shift in focus for the staff managing the process.

How Mi7 Solutions Helped
Mi7 listened closely to CRMC’s project requirements. Once they had a full understanding of the needs and challenges, they collaborated with the team and provided a plan, with suggestions for the best ways to accomplish CRMC’s goals. Extra care was taken to draft the scope of work and clearly define the requirements and end result.

To meet the goal, Mi7 developed a custom reports interface for CRMC, leveraging HL7 language (the standard health care interface language) to allow for the transfer of data. All reports, clinical documentation, lab and radiology results, and others, are easily transmitted through the interface for accessibility to all providers involved in the patient’s care.

Results
There have been many benefits as the result of the implementation of the reports interface. A great deal of time is being saved by eliminating the need to manually fax hundreds of reports between CRMC providers each day. This translates to overall cost savings, and a large burden being relieved from CRMC’s fax system. The patients also see a benefit in that there is more accuracy, and more immediate access to information, which ultimately expedites treatment.

“Mi7 is very detail oriented, which is imperative when you’re working with the type of information involved in the transfer and sharing of patient data. His thoroughness led to a very well-defined scope of work and project requirements, which allowed the project to run very smoothly with no surprises. As we have the need to add new reports to eClinicalWorks, Mi7 is right there with us, adding to the interface as our needs grow. Mi7 is great to work with, and we’ll continue to work with them on future projects.”

Belynda Imhoff, RN, MS
Director, Health Informatics,
Capital Region Medical Center