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EMR-LINK A Fall 2010 Review. Housekeeping. Shrinking the GTM session Being muted. Your Audio Pin Raising hands. We’ll have breaks for questions. Use “Chat” to queue up questions. What We’ll Cover Today. What’s new with orders? Auto-splitting Courtesy copies Billing interface
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Housekeeping • Shrinking the GTM session • Being muted. • Your Audio Pin • Raising hands. • We’ll have breaks for questions. • 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
The Whole Picture Clinic’s EMR-LINK Account Lab Lab compendiums • Point-of-care ABN Validation(Uses lab’s ABN rules) • Rules-based routing (insurance and location) • Clinic specific mappingof EMR-to-Lab data • Order Entry Questions • Requisition printing • ABN printing • Label printing Lab 2 Lab 1 Clinic’s mapping tables Requisition Completion 4 5 6 • HL7 compliant ORM • Complete order information to lab’s requirements HL7 Order Req 3 Routing Rules (choose the lab) Label 7 Lab Requisitioning Database EMR-Link Connector • Manifest Reports • Future Orders • Billing interface back to PM (future) 2 2 • Secure HTTPSdownloads • Auto-Completion • Provider desktop notification 1 3 8 EMR-LinkConnector Lab Result Manager Your Code EMR Order Codes Meds Electronic (HL7) Result LIS LinkLogic Radiology Services Clinic’s EMR
The Billing Interface Clinic’s EMR-LINK Account Lab Lab compendiums • Point-of-care ABN Validation(Uses lab’s ABN rules) • Rules-based routing (insurance and location) • Clinic specific mappingof EMR-to-Lab data • Order Entry Questions • Requisition printing • ABN printing • Label printing Lab 2 Lab 1 Clinic’s mapping tables Requisition Completion 2 • HL7 compliant ORM • Complete order information to lab’s requirements HL7 Order 1 Req Routing Rules (choose the lab) Label Lab Requisitioning Database EMR-Link Connector • Manifest Reports • Future Orders • Billing interface back to PM (future) PMIS 3 4 • Auto-Completion • Provider desktop notification EMR-LinkConnector Lab Result Manager Your Code EMR Order Codes Meds Electronic (HL7) Result LIS LinkLogic Radiology Services Clinic’s EMR
Consolidation For The Practice EMR-LINK Clinic’s mapping tables Order Completion Electronic (HL7) Order Lab Lab Routing Rules (choose the lab) Lab Orders Database EMR-Link Connector Lab • Secure HTTPSdownloads Lab Result Manager Your EMR Order Codes EMR-LinkConnector Meds Electronic (HL7) Results LinkLogic Radiology Services Clinic’s EMR
EMR-Link: Extensible Lab and EMR Connectivity • Labs with Bi- • Directional Integration • LabCorp • Quest • Bio-Reference • CPL (Sonic) • Mullins • Providence • PAML • PeaceHealth • Mercy Medical • Cortland EMR-Link Reference Labs EMR Clinic 1 HospitalLabs EMR Clinic 2 ImagingDepts EMR Clinic 3 Repositories(HIE or public)
EMR-to-Hospital Integration Practice Hospital EMR-Link Orders hospital services Orders PACS Lab ECG • Full text report Results review • Structured results Engine • URL link to image LinkLogic • Link to reporting system • Lab results • ECG reports/images • Radiology results/images • Practice Benefits • Order reconciliation (auto-completion) • Guaranteed chart matching • Link to images (radiology) • Hospital Benefits • Competitive Outreach Services • Increase Referrals to Departmental Services. • Clean orders (decreases write-offs)
Radiology Workflow Improvements • Pre-auth? • Scheduling? • Clinical lists Clinic Imaging • AOE questions • Minimize data entry Order Completion • Req’d insurance • Verified ABN • No data entry • Easy to order • ABN validated Physician Ordering RIS PACS Physician Review • Desktop notification • Updates the order status EMR Chart Matching • Results match to charts • Contains link to the image study
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.
PDF Results Flow Clinic’s EMR-LINK Account Lab Lab compendiums • Point-of-care ABN Validation(Uses lab’s ABN rules) • Rules-based routing (insurance and location) • Clinic specific mappingof EMR-to-Lab data • Order Entry Questions • Requisition printing • ABN printing • Label printing Lab 2 Lab 1 Clinic’s mapping tables Requisition Completion • HL7 compliant ORM • Complete order information to lab’s requirements HL7 Order Routing Rules (choose the lab) Lab Requisitioning Database PDF File Store Link to PDF 4 2 Your EMR Order Codes EMR-LinkConnector Lab Result Manager Electronic (HL7) Result With PDF Meds LIS LinkLogic 3 1 Radiology Services Clinic’s EMR
Health Information Exchanges Health information exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system.
EMR-Link: Extensible Lab and EMR Connectivity • Labs with Bi- • Directional Integration • LabCorp • Quest • Bio-Reference • CPL (Sonic) • Mullins • Providence • PAML • PeaceHealth • Mercy Medical • Cortland EMR-Link Reference Labs EMR Clinic 1 HospitalLabs EMR Clinic 2 ImagingDepts EMR Clinic 3 Repositories(HIE or public)
Implementation Times Improve From 120 hours … to 16 hours • 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……..
Automating The Setup: The Orders Builder Lab Utilization Reports Orders Builder EMR Clinical Kits EMR EMR Orders Builder • 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)
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 timewww.emr-link.com
Results Only Dataflow Lab • 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. Paper Lab Order Clinic’s EMRLINK Account • Queues results for the clinic • Responds to HTTPS requests for downloads. • Secure HTTPSdownloads EMR-LinkConnector Result Manager Lab Order Codes Meds Electronic (HL7) Result LinkLogic Radiology LIS Services Clinic’s EMR Lab Results
Comparing Lab Orders…. Centricity EMR 9.2 And EMR-Link
The Benefits of Centricity 9.2HL7 ORM and assisted order completion. Lab ORM complies with the HL7 ORM orders message needed by the labs. Patient ID in the order guarantees a match to the patient’s chart when the result is returned. Narrows the choices of orders for manual “complete” • HL7 compliant ORM • Patient ID • Provider ID Lab Orders Lab Order Codes Meds LinkLogic Radiology Lab Results LIS Services Clinic’s EMR
EMR-Link adds the following to 9.2 Lab • Billing decisions are made. • Test specific (AOE) Order Entry Questions • Requisition printing • ABN printing • Label printing • Point-of-care ABN Validation(Uses lab’s ABN rules) • Rules-based routing (insurance and location) • Clinic specific mappingof EMR-to-Lab data 1 2 4 Clinic’s mapping tables Order completion 3 Lab Orders • HL7 compliant ORM • Patient ID • Provider ID Orders database 5 • Manifest Reports • Future Orders • Billing messages sent to clinic’s PM. Lab Order Codes Meds • Auto-Completion • Dr. Desktop Notification LinkLogic Radiology Lab Results LIS Services 6 Clinic’s EMR
The Difference…… with EMR-Link you get 9.2 ORM support and. • 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. • 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. • 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. • 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. • 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. • 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 Downloads Centricity EMR Lab EMR-LINK EMR-Link Connector ABN Validation EMR-Link Database Electronic (HL7) Order ORU Message Provider’s Desktop LinkLogic MDM Message With PDF Reference • ResultManager: • 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 PDF File HTTPS Patient’s Chart Electronic (HL7) Result With embedded PDF Clinic’s PDF File store