Allscripts Ehr User Guide
Among current users of McKesson’s Paragon electronic medical record (EMR) system, confidence about Allscripts’ future development of Paragon varies, with current Paragon users equally split on Allscripts ability to improve the technology, according to a new Flash Insights report released by KLAS Research. In August 2017, Allscripts announced their intentions to purchase McKesson's Enterprise Information Solutions (EIS). This announcement comes after a period of uncertainty regarding McKesson’s plans for the future of Paragon and other EIS solutions. KLAS, an Orem, Utah-based market research firm, interviewed current Paragon customers to gauge how they are reacting to the news. Do Paragon clients feel the acquisition puts them in a better position? Does it change any customers’ long-term plans? KLAS’ report reflects feedback from 38 organizations (30 percent of all organizations using Paragon).
According to KLAS, for years, Paragon customers have been significantly disappointed by McKesson’s development efforts. Though Allscripts has done better with development, Sunrise Clinical Manager customers feel the system has room for some improvement, KLAS researchers wrote. Just under half of interviewed Paragon customers (42 percent) are withholding judgment as to whether Allscripts’ development of Paragon will be meaningful. Another 29 percent are confident that Allscripts will continue to develop and improve Paragon. “They believe Allscripts is looking to fill a gap, and they see the acquisition’s lower price point as a signal that Allscripts plans to put additional R&D resources into Paragon,” the report authors wrote.
Allscripts Practice Management User Manual
However, an equal number (29 percent) are doubtful. “They feel developing Sunrise Clinical Manager and Paragon will divide Allscripts’ focus, and they view the lower purchase price as evidence that Allscripts doesn’t think Paragon is salvageable,” KLAS researchers wrote. The report included comments from healthcare organization respondents. One healthcare organization leader commented, “Paragon has been a highly clunky and repetitive tool for us. In order for us to reconsider leaving, the changes would have to be sweeping and immediately attractive and come with strong incentives.” Another healthcare organization respondent said, “Paragon has a great foundation and some good parts, but McKesson couldn’t make it work while focusing on pharmaceuticals.
Moving it to a healthcare company makes sense, but the price suggests that Allscripts could just scrap it.” Overall, the majority of Paragon clients (76 percent) say the acquisition does not change their future plans. One-quarter of interviewed Paragon customers say the announcement will potentially change their long-term plans—this group is split between those who were previously planning to leave but are now reconsidering (13 percent) and those who were planning to stay but are now reconsidering (11 percent), the report states. “Of the 13 percent already planning to leave, many like that Allscripts is solely focused on healthcare software (unlike McKesson) and believe Allscripts will invest the resources needed to make Paragon successful.
Of the 11 percent who were previously planning to stay, some have had poor experiences with Allscripts in the past or fear that Allscripts is repeating McKesson’s mistake of trying to develop two EMR platforms. The biggest portion of respondents are organizations whose plans have not changed following Allscripts’ announcement,” KLAS researchers wrote. Time will tell whether some larger Paragon customers will consider Allscripts Sunrise Clinical Manager in their go-forward decisions. Most interviewed customers (68 percent) feel that Allscripts’ announcement does not improve or worsen their position with Paragon—this includes organizations who have already made decisions to leave Paragon, those who feel stuck with the product, those who are waiting to see what Allscripts will do and those who are satisfied with Paragon. One-quarter of current Paragon users believe their position has improved with the Allscripts acquisition. The KLAS research also found that the clock is ticking for Allscripts to improve Paragon as frustrated Paragon users are hoping for rapid development. “Many interviewed customers agree that if Allscripts is going to entice Paragon customers to stick around, they are going to have to move quickly to provide not just a strategy but actual improvements to Paragon’s functionality and support,” the KLAS researchers wrote.
From a market perspective, KLAS also notes that Allscripts’ acquisition moves the company up to fourth place in terms of total U.S. Market share.
Sunrise Clinical Manager’s market share has grown incrementally over the past three years, and satisfaction with SCM has been steady over the past five years, according to KLAS. “SCM hasn’t kept pace with the market leaders in terms of new contracts or overall mindshare. With the acquisition of Paragon, Allscripts has an opportunity to turn around Paragon customer satisfaction and market share, which have both plummeted over the past several years as a result of slow development and the uncertainty created by McKesson’s divestment of other HIT products,” the KLAS researchers wrote.
Two-thirds of physicians say the challenges of practicing medicine in today’s environment have caused them to consider career options outside of clinical practice, an 11 percent increase compared to a similar survey three years ago. Most physicians surveyed (89 percent) say the “business and regulation of healthcare” has changed the practice of medicine for the worse.
The intensity of agreement has increased over time; today, 57 percent strongly agree, up from 48 percent in 2015, according to a survey of 300 full-time physicians by Geneia, a Harrisburg, Pa.-based healthcare analytic solutions and services company. According to Geneia’s Physician Misery Index, a tool the company established to measure national physician satisfaction, the physician misery index has increased to 3.94 out of 5, since the January 2015 inaugural survey. The survey found that 87 percent of surveyed physicians say they find it is increasingly harder to spend time “developing an authentic engagement with each patient,” and 80 percent say they are personally at risk for burnout at some point in their career. Nearly all surveyed doctors (96 percent) report they have personally witnessed or personally experienced negative impacts as a result of physician burnout.
What’s more, 86 percent of surveyed physicians agree with the statement: The heightened demand for data reporting to support quality metrics and the business-side of healthcare has diminished my joy in practicing medicine. Geneia’s survey also indicated that physicians continue to be challenged by the electronic health record (EHR). About two-thirds (68 percent) of physicians say the data collected by EHRs isn’t being used and analyzed to its full potential. Almost all of the respondents (96 percent) believe it’s important for EHRs to be better designed so they seamlessly integrate with technology systems used by their office and insurers.
Despite increasing awareness of pervasiveness of physician burnout, the nationwide Physician Misery Index has increased from 3.78 in January 2015 to 3.94 out of 5 in this most recent survey, the company said. The survey also revealed a physician burnout gender gap. Female physicians, in particular, are frustrated by the challenges of practicing medicine and expressed greater dissatisfaction than their male counterparts. Female survey respondents are more likely to know a physician who is likely to stop practicing medicine due to burnout (77 percent compared to 67 percent of men).
Women are considering options outside clinical practice at a higher rate (73 percent), as compared to men (62 percent). Female physicians also are more at risk for burnout at 89 percent, compared to male physicians at 76 percent. “In the years since Geneia’s inaugural Physician Misery Index, awareness of epidemic levels of physician burnout has increased dramatically,” Heather Lavoie, Geneia president, said in a statement. “Yet, there is much more work for all of us in healthcare to do to restore the Joy of Medicine to today’s physicians. We’re calling on all health IT companies to involve physicians in the design and implementation of health technology products and to measure physician satisfaction.” Physicians interested in taking the health IT satisfaction survey can find it. More From Healthcare Informatics. Providing an update on Cerner’s progress with the Department of Defense’s (DoD) electronic health record (EHR) implementations, a company executive noted that he is seeing “measurable progress” at the DoD’s initial operational capability (IOC) sites.
The EHR overhaul contract for the DoD, called MHS Genesis, and which was awarded in 2015 to Cerner, Leidos and others, is currently valued at $4.3 billion with a total contract lifecycle value of $9 billion if all options are exercised. That the contract ceiling will be raised by $1 billion, and that the additional funding will include the Coast Guard in the project. According to some media reports throughout this year, the initial feedback on the four military site EHR rollouts has been less than ideal. This past spring, a Politico that detailed the first stage of implementations noted that it “has been riddled with problems so severe they could have led to patient deaths.” Indeed, some clinicians at one of four pilot centers, Naval Station Bremerton in Washington, quit because they were terrified they might hurt patients, or even kill them, the report attested. In October 2017, Madigan Army Medical Center in Takoma, Wash.
Became the to go live with the MHS Genesis EHR system. That deployment followed installations at Fairchild Air Force Base, Naval Health Clinic Oak Harbor and Naval Hospital Bremerton.
The new EHR system is expected to be deployed at every military medical facility in phases over the next five years, and a recent report noted that the DoD is moving onto a. For years, healthcare institutions have attempted to manage paper documents and electronically captured PDF files. These documents can be electronically stored in various databases like EHRs, ERPs. Executives at the Defense Healthcare Management Systems, the office in charge of the EHR modernization projects, have of late, despite the negative media reports. And now, in a, Travis Dalton, president, Cerner Government Services, stated that he recently visited the four DoD sites that have deployed the Cerner system, noting that he is “encouraged by the progress being made and the direction we are now headed. Even in this early stage, thanks to the leadership at each site, we’re seeing improvements in patient safety, patient care and efficiency. We are seeing measurable progress at the IOC sites,” he said.
Dalton pointed to specific areas of progress with use of the IT system, such as: approximately a nine-minute improvement in the time from when a patient arrives at the emergency department (ED) to when they see an ED provider in the first two months post go-live; avoiding approximately 2,300 duplicate orders of four commonly placed lab orders from January through June; avoiding more than 400 duplicate chest X-rays from January through August; and increasing the number of online portal messages between patients and their care teams by more than 40 percent in the first 60 days post go-live. Dalton further noted that the number of patients seen in ambulatory locations has increased by 33 percent and the volume of necessary prescriptions and refills have increased by 65 percent at these sites. Speaking to the hurdles that the initial implementation sites have experienced thus far, while Dalton did not mention any of the specific patient safety concerns mentioned in media reports, he said that “We’re well accustomed to the initial hurdles that come with a technology implementation. With the DoD, our goal was to identify challenges and fine-tune processes early, so we proactively sought feedback a few different ways.” To this end, he said that the DoD’s Joint Interoperable Test Command conducted an Initial Operational Test & Evaluation at the four IOC sites, which “confirmed some of the challenges the team was already working to resolve. Though some have portrayed the report’s findings as a setback for the program, these reports accomplished exactly what we intended,” he said. Back in January, it was announced that the MHS Genesis rollouts would be suspended, with the goal to assess the successes and failures of the sites where the rollouts had already been deployed.
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Meanwhile, regarding the VA modernization project, a that was also awarded to Cerner, back in May, Dalton stated that “Cerner and the agency are committed to applying commercial best practices, as well as any lessons learned from our DoD experience, to the VA’s Electronic Health Record Modernization (EHRM) program. The VA has unique challenges and it’s critical that end-users and stakeholders are engaged throughout the implementation process,” he said. Adding to this point, he noted that Cerner recently hosted more than 400 stakeholders, including Veteran Service Organizations, government officials from the VA, DoD, Office of Management and Budget, and industry partners at its company headquarters in Kansas City, Missouri for a program kickoff. In a from the DoD and VA Secretaries about a month ago, the two agencies signaled their commitment to achieving interoperability by implementing a single, seamlessly integrated EHR. The hope inside the federal agencies is for both departments to standardize on Cerner’s EHR. The idea is that this will provide a more complete longitudinal health record and make the transition from DoD to VA more seamless for active duty, retired personnel and their dependents. Once completed, the project would cover about 18 million people in both the DoD and VA systems.
As Healthcare Informatics, while interoperability between the VA and DoD has been a long-standing goal for both agencies, and the past two decades has seen the agencies making strides to achieve interoperability between two separate health IT systems, progress on this front has been slowed by both operational and technical challenges. Nonetheless, Dalton wrote in his post, “These efforts will achieve more efficient interoperability for the DoD and VA—creating a single health record across more than 1,700 health care sites and a lifetime of seamless care for nearly 20 million Servicemembers, Veterans and their beneficiaries. We’re in the early phases of this transformation.
It’s a complex endeavor that will take time and involve asking passionate health care providers to change some of the processes they’ve been using for decades,” he said. By implementing electronic medical record (EMR)-based interventions, Boston Medical Center was able to reduce unnecessary diagnostic testing while increasing the use of postoperative order sets. These actions signal two markers of providing high-value medical care, according to hospital officials. Indeed, the data from Boston Medical Center’s efforts demonstrates the impact of deploying multiple interventions simultaneously within the EMR as a way to deliver high-value care, they attest. Was published in the Joint Commission Journal on Quality and Patient Safety. The focus on providing high-value medical care was renewed in 2012 with the release of the, an initiative of the American Board of Internal Medicine Foundation that identifies common tests and procedures that may not have clear benefit for patients and should sometimes be avoided. Many institutions have responded to this campaign by developing EMR-based interventions that target individual recommendations.
Boston Medical Center (BMC) specifically focused on five areas in the Choosing Wisely recommendations: the overutilization of chest x-rays, routine daily labs, red blood cell transfusions, and urinary catheters, and underutilization of pain and pneumonia prevention orders for patients after surgery. To do this, the researchers worked with the hospital’s IT team to incorporate new recommendations into the EMRs that would alert the provider to best practice information.
The researchers examined data between July 2014 and December 2016 to look at how the interventions played out clinically. At six months following BMC’s intervention, which was activated hospital-wide for specific patients using the Epic EMR, the proportion of patients receiving pre-admission chest x-rays showed a significant decrease of 3.1 percent, and the proportion of labs ordered at routine times also decreased 4 percent. Total lab utilization declined with a post-implementation decrease of 1,009 orders per month, the study revealed. The researchers found no significant difference in the estimated red blood cell transfusion utilization rate or the number of non-ICU urinary catheter days, but the proportion of postoperative patients who received appropriate pain and pneumonia prevention orders showed an absolute increase of 20 percent, according to the researchers.
“The results from our interventions suggest that they alone show promise in improving high-value care, but using only an electronic medical record intervention may not be adequate to achieve optimal outcomes emphasized by Choosing Wisely,” said Nicholas Cordella, M.D., the study’s corresponding author, a fellow in quality improvement and patient safety at BMC, and an assistant professor at Boston University School of Medicine. Cordella added, ““In order to move the needle on reducing unnecessary healthcare costs, we need to consider multi-pronged approaches in order to engage providers in ways that can truly make a difference in how we deliver exceptional, high-value care to every patient.” He suggested that future efforts aimed at increasing high-value care should consider other elements, such as clinician education, audits and feedback, and peer comparison.
Keeping up-to-date with the EHR software market is like running alongside an accelerating train. For a moment or two it’s possible to keep pace, but before long the relentlessness of product launches and supplier announcements makes it near impossible. If you’re involved in assessing or implementing EHR, a thorough understanding of EHR vendors is an essential part of delivering a successful project. That’s why EHRinPractice.com has created its EHR Vendor Directory. Updated monthly, the guide gives you an accurate reference to the major active EHR vendors in the USA and Canada.
The guide features:. full page vendor profiles. overview of each vendor's current EHR products.
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