Transcript the presentation - Data Drivers

#centricitylive
Disclaimer
The content of this presentation
represents the views of the author and
presenters.
 GE, the GE Monogram, Centricity and
Imagination at Work are trademarks of
General Electric Company.
 Ortho NorthEast is affiliated with Data
Drivers

Objectives
Discover how orders can be used for
documenting procedures and as a tool
to automatically populate forms
 Learn how to generate individualized
educational materials based on
previously answered questions
 Discover how aftercare codes can be
easily added through custom EMR
forms and used to calculate global
periods
 Learn how transcription costs can be
reduced or completely eliminated

Presenters
Mike Baeske, Software Applications
Specialist – Team Leader, Ortho
NorthEast (ONE)
 Tom Pawlik, Supervisor, Surgical
Services / EMR Workflow & Design
Specialist, Ortho NorthEast (ONE)
 Rhonda Draper, Director, Patient Care
Services, Ortho NorthEast (ONE)
 Krista Bennett, Clinical Supervisor,
Ortho NorthEast (ONE)

Ortho NorthEast
An Orthopedic practice founded in 1962
 12 locations throughout northeast
Indiana
 26 physicians, 7 anesthesiologists, 13
CRNAs, 23 mid-levels, 14 PT/OT
 Part ownership of orthopedic hospital,
ambulatory surgery center, and MRI
center

Software Used
Centricity™ EMR 9.5 / CPS 11
 Visual Form Editor1
 SQL Server Business Intelligence
Development Studio

1©
2001-2012 Logical Innovations http://visualformeditor.com
Procedure Workflow
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Previous Workflow
Doctor would handwrite a small paper sheet
with the procedure details
 Paper sheets cost money and can run out
 Filled out requests could get lost before
being processed
 Interpreting handwriting can cause mistakes
 Information has to be reentered in other
areas

New Workflow
Key Features
Navigation buttons used to move
between forms
 Mandatory fields enforce minimum
information gathered
 Dynamic lists of patient information and
doctor’s preferred vendors / special
needs
 Clinical decision support information
visible including allergies and narcotic
contract

Navigation Buttons Programming Tips





OPEN_FORM_COMP() used to open forms
already in the update
ADD_FORM_COMP() used to add a form into
the encounter
GET_FORM_LIST() returns list of forms
already in the update
Match() determines if a string is in another
string or array
Example:
if (match(GET_FORM_LIST(),"Procedure Order")>0) then
OPEN_FORM_COMP("Enterprise\ONE\Surgery Scheduling\Procedure Order", "")
else
ADD_FORM_COMP('Enterprise\ONE\Surgery Scheduling', 'Procedure Order', '','OPEN')
endif
Mandatory Fields Setup Tips

Enable expression determines if object
can operate

Visibility regions utilized to change color
of headers
Key Feature: Physician Protocols
Automatic Physician Protocols
Saves Clicks
 Reduces the chance of forgetting rules
 Allows substitute support staff to help
with limited additional training

Physician Protocol Programming Tips

Watcher statements used to constantly
monitor for conditions
 Example:

Hidden document object used as a lock
to prohibit reevaluation (global variables
should be avoided)
Physician Protocol Easy Button
Order Generated
Ordering Tips

MEL_ADD_ORDER() used to create the
Surgery order
 Order must match the description in settings
 Referrals cannot be generated

Test Order can be used for documentation
and tracking
 Instructions can be altered until sent out
 Administrative comments can be altered until
completed or canceled
Automatic Flagging
Based on the answered questions, flags are
automatically sent to properly notify staff
 Saves staff time and prevents issues with
people forgetting to notify the proper
channels
 MEL_SEND_FLAG() used to send
automatic flag (Not present in older versions
of EMR)
Example:

MEL_SEND_FLAG("Flag",<Receiving Username>,
'Normal‘, str(._todaysdate),<Title>,<Message Body>,'Update','')
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Previous Workflow
Marked on paper order where the
procedure needed to be scheduled and
then scanned into EMR
 Staff work was not traceable and
assistance could not be provided if the
workload was overwhelming
 Not possible to provide decision making
tools, had to rely on staff to remember
the proper protocol

New Workflow
Key Features
Scripting makes it easy for the staff to
do the right thing
 Cases can be used to pull information
from the original request
 External information can be accessed
with a click of a button (information can
be maintained by business staff)

 RUNSHELLOPEN() used to open server
files or webpages

Data entered is reportable
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Key Features
Can use order instructions from original
request and not have to manually type
appointment notes
 Computer text is legible versus
handwritten instructions
 Able to generate Surgery Lists based on
appointments

Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Previous Workflow
New Workflow
Clearance Letters
Building Pre Op Orders
Key Features
Information pulled directly out of order
created by clinical staff
 Able to build upon health history
collected during office visit
 Links to reference information on the
server
 Generate labs, clearance letters, and
pre op orders that can be printed with a
click of a button or sent through secure
messaging
 Create educational and instructional
material for the patient

Programming Tip
ORDERS_ALL(“delimited”) will return
every order in the orders module
including Complete and Canceled
 Getfield() will divide up text into an array
 Sub() retrieves portions of text based on
a specified character range

Surgical Cases
Surgical prep work takes an extended
period of time
 To prevent blocking, document is signed
and values are saved to observations
 Multiple sets of observations were
required for concurrent surgical
preparation
 Tracking tool was developed to assist
with working on the case

Facilitator Checklist
Procedure Workflow
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Changes
and
Cancellations
Changes and Cancellations
Key Features
Flags sent out depending on who is
using the form
 Form layout ensures the staff will
complete all steps necessary
 Provides documentation that can be
reported and referenced by other staff

Procedure Workflow
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Previous Workflow
Doctors would dictate their procedure
notes
 Coders would have to manually enter
codes in the billing visit based on the
dictation

Documenting and Billing
Key Features
Documentation templates provide a simple
tool to record the procedure details without
paying an outside company
 Form layout allows manipulation to
documentation to specify details about the
unique procedure

 Avoids “cookie cutter” documentation

Billing is done by the clinical staff but
bypasses the click heavy orders module
Procedure Workflow
Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Creating the Status Post
Key Features
Uses the information built by all the
previous steps to generate status posts
 Clears out the observations so the case
will not show up in the future
 Provides a relatively easy way to
generate the aftercare codes

Office Visit
Completing
the
Case
Documenting
and
Billing
Navigation
and
Scheduling
Pre Op
Coordination
and Education
Previous Workflow
Manually reentered information into
dictation and problems list
 Coders had to fix global period issues
and incorrect CPT codes

Post Op Recheck
Key Features
Pulls information already entered and
modified during the entire workflow
 Global period is automatically
determined by CPT code and date of the
procedure
 Ability to denote infection control steps
need to be started

Surgery Lists

Surgical Staff work list
 Shows detailed list of procedures being
done throughout the day

X-ray Summary
 Provides a concise list to forward to hospital
to verify all X-rays were received

Vendor work list
 Provides detailed information for specific
patients relevant to the vendor
Surgical Staff work list
X-ray Summary
Vendor List
Surgery Cancelations / Changes
Allows staff to see trends in why
procedures are being canceled
 Dependent on appointment cancelation
reasons in CPS

Navigation Reporting
Physicians want to know why patients
are being scheduled at certain locations
 Report built on navigator form details

Infection Control

Inquiry used to show all potential post
operative infections
Infection Control

Form used to document full infection details
#centricitylive