Author Archives: Hugh Martin

Eric Garnett, Clinical Specialist – Emergency Services at the TriStar Health Division of HCA, presented an educational session at the 2015 International MUSE Conference entitled Implementing Improved Discharge Instructions in Meditech Magic at HCA. Dr. Chris Galassi, CEO and Product Director for Discharge 1-2-3™ Callibra, Inc., co-presented. HCA is integrating Discharge 1-2-3 software into all its hospitals that use Meditech Magic with plans to upgrade to Composer this year.

The presentation showed how good discharge instructions contribute to patient outcomes and organizational success, and demonstrated how discharge instructions can be upgraded in large, matrixed organizations that use Meditech Magic. Topics covered include:

• How discharge instructions contribute to outcomes, safety, and performance
• What HCA looks for in discharge instructions
• Challenges HCA has faced regarding discharge instructions in the past
• How HCA is implementing this new solution system-wide
• Value to HCA of integrated, customizable discharge instructions

According to Dr. Galassi, it is believed that ninety million Americans have difficulty understanding their own care, and that between forty and eighty percent of information communicated is forgotten by the time a patient gets home. Recent studies confirm that discharge instructions:

• Can reduce readmissions when combined with follow-up by hospital staff
• Improve quality of patient care
• Increase patient satisfaction
• Strengthen hospital finances
• Reduce risk
• Support regulatory compliance

Eric indicated that the 15 hospitals in HCA’s TriStar Division together discharged 610,000 emergency department patients last year. TriStar has high standards for its discharge instructions, which include the following criteria:

• Patient-specific
• Evidence-based
• User-friendly
• Easy to support
• Compliant with regulatory requirements
• Integrate into Meditech Magic
• Include meds, follow up, excuses

Although implementing the new solution across such a large system has presented challenges, the project has been well-managed and according to Eric has already demonstrated significant value for TriStar and HCA:

• Integrates with existing Meditech system
• Improves clinician efficiency
• Compliant with Meaningful Use
• Approach is flexible and scalable

Please drop me a line if you would like to see the entire presentation.

Thanks,
Hugh Martin
Discharge 1-2-3
hmartin@discharge123.com

Dr. Chris Galassi, Discharge 1-2-3™s CEO and Product Director, and Kathy Davis, Sr. Product Manager for Allscripts ePrescribe, presented on ePrescription Research and Usage in Allscripts ED at the Allscripts Client Experience (ACE) conference in Chicago on Thursday, August 14. Discharge 1-2-3 recently integrated Allscripts ePrescribe into its Composer software, and the new version–Composer eRx– will be available to Allscripts ED hospitals later this year.

Galassi chronicled the growth and benefits of eprescription and demonstrated how eprescribe will function within Discharge 1-2-3’s Composer software, while Davis detailed the regulatory requirements for electronic prescribing for controlled substances (EPCS).

In 2013, according to Surescripts, 58% of eligible prescriptions in the US were routed electronically, representing a 32% increase in volume over the previous year. This rapid adoption took place because eprescription is now a Meaningful Use measure for both hospitals and professionals. ePrescription drug overdose surpassed traffic deaths as the leading cause of preventable death in 2011, and two out of three prescription errors are caused by illegible handwriting, misunderstood abbreviations, and unclear dosages. Prescription fraud continues to be a substantial problem despite efforts to create tamper proof prescription materials.

ePrescribing reduces medication errors:

• More than 1.5 million patients injured annually by drug errors.
• One study estimated that each preventable adverse drug event (ADE) that took place in a hospital added about $8,750 to costs.
• Handwritten prescriptions are often difficult to read, requiring pharmacy callback for clarification.

The benefits of eprescribing are now well-known and include:

Improved patient safety – fewer ADEs.

• Increased efficiency – less time wasted clarifying prescriptions.
• Better medication adherence – promotes appropriate drug usage.
• Cost savings – fewer preventable ADEs and improved throughput.

Finally, Galassi demonstrated how Discharge 1-2-3’s Composer seamlessly integrated Allscripts ePrescribe into the Allscripts ED workflow.

If you would like more information about Composer eRx, please contact us info@discharge123.com.

Thanks,
Hugh Martin
Discharge 1-2-3
hmartin@discharge123.com

Discharge 1-2-3 debuted three new products at the Allscripts Client Experience (ACE) conference last week in Chicago:

• Composer eRx™ enhanced version of this award-winning software for Allscripts ED hospitals that seamlessly integrates Allscripts ePrescribe into discharge instructions workflow.
• Composer for Sunrise™ Composer™s easy and fast point and click customization and advanced integration will soon be available to Sunrise hospitals.
• Arabic language content – Arabic joins Spanish, Chinese, French, Vietnamese, Russian, and Somali discharge instructions and patient education content available in bi-lingual format.

Dr. Chris Galassi, Discharge 1-2-3’s CEO and Product Director, presented on two topics:

• ePrescription Research and Usage in Allscripts ED, with Kathy Davis, Sr. Product Manager for Allscripts ePrescribe, on the conference’s Allscripts ED track.
• Discharge Instructions Research and Compliance, on the Sunrise track.

Reaction to the new products was very positive, as you can see by this post from a Sunrise user who visited the Discharge 1-2-3 booth and saw a demo of Composer:

Please contact us at info@discharge123.com you have any questions about Composer eRx for Allscripts ED, Composer for Sunrise, or Arabic content for discharge instructions and patient education.

Thanks,
Hugh Martin
Discharge 1-2-3
hmartin@discharge123.com

Just returned from the 2014 International MUSE (Medical Users Software Exchange) Conference in Dallas. MUSE is a community of Meditech users and partners, and this year’s conference was attended by 683 users from 186 hospitals and 538 representatives from 131 vendors. Although attendance was down from last year’s event in Washington, DC, everyone I spoke with thought the conference was useful

The MUSE conference is a great window into the issues facing the Meditech user community. With at least 1,200 hospitals that use three different versions of the Meditech EMR 6.X, Client Server, and Magicit’s always a spirited conversation. The Meditech corporation maintains a presence at MUSE, but it doesn’t stage manage the event the way some other EMR vendors do their user group meetings.

Discharge 1-2-3 demoed our newest version of discharge instructions that integrates with Meditech Magic. We also enjoyed visiting with existing clients and partners and meeting new ones. A highlight of the week was a visit to long-time customer Cook Children’s in nearby Fort Worth. Cook Children’s uses Discharge 1-2-3 software with its Meditech Client Server system.

Dr. Chris Galassi at Cook Children’s

Here are some high-level take-aways from this year’s MUSE:

• Many Meditech users expressed the opinion that Meditech’s existing PDI system could be improved upon. We heard a number of comments about the inability of a clinician to customize on the fly and the quality of some content.
• Meditech shared their strategic vision of the future, which includes being cloud hosted and web-centric and improved content management. Management also made it clear that they understand they don’t always have the best solution for every situation and they are increasingly collaborating with partners and third-party vendors.
• The move towards pay for performance is entering a crucial phase as Accountable Care Act incentives wind down and potential penalties ramp up. Including Readmissions, VBP, HAC, and MU, hospitals will soon have 7% of their Medicare revenues at risk. MU criteria that seem to have been particularly difficult to attest to include CPOE and patient portal.

What were your take-aways from MUSE?

Thanks,
Hugh Martin
hmartin@discharge123.com

Discharge 1-2-3 was a part of HIMSS14 in Orlando, where it demonstrated its discharge instructions and patient education. One of the major themes of the conference was the industry move towards interoperability. Discharge 1-2-3 is a leader in the area of interoperability and its solutions currently work with major EMR/EHRs such as Epic, Allscripts, Meditech, Cerner, McKesson, Siemens, and CPSI.

We welcome Valley Health, headquartered in Winchester, VA, to the Discharge 1-2-3 user community. Valley Health just chose our content for their six emergency departments. Like many other discerning Epic users, Valley Health was dissatisfied with their existing content and chose to switch to Discharge 1-2-3.

Valley Health operates six hospitals: Winchester Medical Center, in Winchester, VA, Warren Memorial Hospital, in Front Royal, VA, Shenandoah Memorial Hospital in Woodstock, VA, Page Memorial Hospital in Luray, VA, Hampshire Memorial Hospital in Romney, WV, and War Memorial Hospital in Berkeley Springs, WV. Each year Valley Health discharges approximately 140,000 patients from their emergency departments.

At last week’s Essentials of EM Conference in San Francisco hosted by Mel Herbert, MD, Greg Henry, MD, past president of ACEP, gave the keynote address. He reminded us how important it is for discharge instructions to be concise. Then he asked his audience how many of them gave 10-page discharge instructions. When it became obvious that for many this was common practice, he challenged us to be brief by stating:

“The amount of discharge instructions the patient actually reads is inversely proportional to how long they are.”

Rick Bukata, MD, another leading Emergency Department clinician and educator, weighed in on the same theme last year. In his Emergency Physicians Monthly article “With Discharge Instructions, Less is More,” he questioned the merit of substituting quantity for quality. Specifically, he wrote:

“The trend of voluminous, exhaustive discharge instructions puts the pressure on patients to understand and identify complex risk factors, like infection. According to the research, this is probably a bad idea. . . . Some people seem to think that if discharge instructions are a good thing, then the more the better.”

Why aren’t discharge instructions more short and to the point? You’ve undoubtedly heard Mark Twain’s quote:

“I didn’t have time to write a short letter, so I wrote a long one instead.”

Concise discharge instructions are:

• More patient-specific
• More likely to be read by the patient
• Less likely to confuse the patient

And concise discharge instructions contribute to:

• Improved patient outcomes
• Increased patient satisfaction
• Better risk management

As several Emergency Department thought leaders have recently reminded us, discharge instructions need to be concise and to the point.

Are your discharge instructions short and sweet?

Chris Galassi, MD
CEO, Discharge 1-2-3

We welcome The University of Wisconsin Hospital and Clinics in Madison, WI, to the Discharge 1-2-3 user community. Like a number of other discerning Epic users, UW wasn’t satisfied with the quality of their existing ED content and chose to switch to Discharge 1-2-3.

We’re happy to share that the partnership is off to a great start and that initial feedback is very positive. ED physicians feel the content is better that what they previously had, and that the options are more specific, especially for peds. They really like the foreign language instructions. We’ve also received feedback and suggestions from the UW clinicians which is being incorporated into the content libraries as they are updated.

On Wisconsin!

Hugh Martin

Focused and aggressive best describe the tone of the Allscripts Client Experience 2013 (ACE13) conference at McCormick Place in Chicago two weeks ago. As a long-time Allscripts partner, Discharge 1-2-3 joined nearly 4,500 other clients, staff, partners, and industry representatives to share priorities, plans, and ideas for improving system performance and compliance. We came away impressed.

Allscripts President and CEO Paul Black laid out the firm’s five areas of primary focus during his address:

1. Meaningful Use Stage 2 compliance.
2. ICD-10 implementation.
3. Integration of solutions and data.
4. Making the next upgrade much stronger than the current version.
5. Innovation in all areas.

In addition to imparting new organizational goals, other major themes for the conference included population health, interoperability, and analytics. Keynote speakers Rasu Shrestha, MD, Vice President of Medical Information Technology at University of Pittsburgh Medical Center, and Vinay Vaidya, MD, Vice President and CMIO of Phoenix Children’s, shared examples of how their institutions were using data to improve consumer empowerment and patient safety, respectively.

“He who tames the data, wins,” said Dr Shrestha. We couldn’t agree more.

Hugh Martin