Medical/Dental Professionals

Information Technology

Schedule a Session with an EMR Coach

One of the recently completed go lives was an optimization of workflows for several groups of physicians and advanced practice providers.  
Providers who would like to make significant gains in efficiency are invited to request one-on-one, at-the-elbow support from an EMR Coach.  

The EMR Coach will observe current workflows and provide suggestions about how to increase efficiency and gain time back in your day. 

Providers who would like to take advantage of this service are encouraged to contact the Technology Assistance Center. Call 716-859-7777, press 1, and ask for an EMR Coach.

‘Engage’ Appointment Reminder Reduces the Number of No-Shows

Phase II of Engage, Kaleida Health’s new automatic appointment reminder system, goes live on April 18. The Information Technology Engage project team began rolling out the new system to ambulatory clinics on a pilot basis in February. The majority of the remaining Kaleida Health outpatient clinics will be enrolled during this phase.

“The outpatient programs are all very excited to have this enhancement to their scheduling process,” said Steven Moll, director of ambulatory clinics. “We expect a significant improvement in patient satisfaction and adherence to their scheduled appointments.”

The appointment reminders are sent by text or phone message to patients one week out followed by a reminder two days in advance of the appointment, unless it has been canceled. That’s one major advantage of the automated system. Early cancellations cut down on the number of no-shows, giving clinics the opportunity to “backfill” slots that open up, which increases productivity and revenue.

So far, since the pilot launch in mid-February, 6,897 reminders have been sent by phone message or SMS. Of those appointments, 2,504 were confirmed and 304 were canceled.

“That’s 304 opportunities for schedulers to reassign appointments, reducing down time in the clinic and wait time for patients who want to get in to see their doctor,” said Seema Moudgil, director of specialty services.

Patients choose their preference for receiving text or phone message reminders at the point of service. Updates to contact information and communication preferences are managed through the Kaleida Health electronic medical record.


Interactive TV System a ‘Game-Changer’ for Improving Patient Satisfaction

Every television in every patient room in Buffalo General Medical Center/Gates Vascular Institute (BGMC/GVI) and Millard Fillmore Suburban Hospital (MFSH) will soon be replaced with a new, state-of-the-art TVR/pCare interactive TV. Now, in addition to watching TV to pass the time during their hospitalization, patients can also use the TV to communicate with their caregivers.

“Patients can answer questions about their stay and provide real-time feedback to their care team through the TV,” said Charlene Ludlow, chief quality and patient safety officer for Kaleida Health. “This will help us resolve patients’ concerns right away rather than waiting until we receive their HCAHPS survey.”

The TVs are being replaced at BGMC/GVI and MFSH thanks to a million-dollar donation from local restaurateur and hospital benefactor Russell J. Salvatore. He also donated $500,000 to include the interactive TVs in the new Oishei Children’s Hospital (OCH) when it opened in 2017. After the BGMC/GVI installation is complete crews will move on to MFSH.

The interactive TV system adds a powerful new tool to improve the patient experience proactively rather than reacting to HCAHPS scores after the fact. It has already proven its worth at OCH. An average of 200 surveys per unit per month are being received, providing a treasure trove of data. Survey measures include how frequently patients are being checked in on, whether their calls lights are being answered in a timely manner, and whether doctors are listening and explaining the patient’s plan of care.

“There’s a lot we do to make sure our patients and families are well taken care of and are fully satisfied with our services,” said Audrey Tobin, BSN, RN, a nurse manager at OCH. “The TV surveys are a huge game-changer in that they are sent in real time.”

As soon as a patient or family member completes a survey a notification is automatically emailed to the nurse manager and his or her director, giving staff the opportunity to correct issues as they arise. Ordinarily, caretakers wouldn’t see a negative HCAHPS survey until after discharge, when it’s too late to do anything about it.

“We want to be proactive in meeting our patients’ needs,” said Ludlow, “and the interactive TV is a great communication tool for doing just that.”

EMR Solution Suppresses Nuisance Alerts, Improves Provider Experience

So-called “nuisance alerts” generated automatically by electronic medical records (EMRs) are actually more than just a nuisance. Studies indicate that most alerts are ignored due to the frequency of “false alarms.” This can compromise patient safety if a truly important alert is ignored due to “alert fatigue.”

Medication Management Alerts is the newest enhancement to the Great Lakes Integrated Medical Record (GLIMR) currently in use across the Kaleida Health system and designed to become the EMR for all of Great Lakes Health in the next few years. The Medication Management Alerts solution goes live on April 23, 2019.

It identifies nuisance alerts that are appropriate to remove from a clinicians’ view, which means that only the most meaningful alerts will to continue to show, eliminating distractions and adding to the efficient use of GLIMR. The GLIMR project’s clinical advisors and Cerner consultants met with providers and pharmacists to identify alerts that could be suppressed without affecting patient safety.

According to Rachel Hagemann, RPh, lead learning facilitator for Cerner, there are multiple reasons why EMRs are prone to sending nuisance alerts. These include the conservative nature of content produced by commercial vendors and a lack of context from failing to consider the available data, objectives, role and venue of care.

“The approach to reducing nuisance alerts has been to reduce the noise, not to make them more meaningful,” she said. “Cerner solutions no longer filter medication alerts that are a nuisance, but create meaningful alerts that enhance safety and improve patient care.” The solution to nuisance alerts, then, is not just turning alerts off but also making the alerts that stay active smarter and more relevant to each patient and his or her circumstances.

The Medication Management Alerts solution suppresses only the alerts listed here. Alerts that are not on this list will continue to fire without change.

Order detail filtering based on analgesic prn reasons
Suppress duplicate therapy alerts during ordering and verification for acetaminophen, narcotic analgesics, narcotic analgesic combinations or NSAIDs if the PRN pain reason differs.

Order detail filtering based on steroid routes reasons
Suppress duplicate therapy alerts during ordering and verification for glucocorticoids, bronchodilator combinations or inhaled corticosteroids when one ordered route is inhalation while the other is oral, IV push, IV piggyback or IV continuous.

Discontinue on scratchpad filtering
If there is an order on the scratchpad that has a status of Cancel, Discontinue, Delete or Void and an interacting order is placed, the mCDS alert will be suppressed.

PowerPlan filtering
Suppress duplicate therapy alerts and drug-drug interaction alerts between orders placed within the same PowerPlan. Alerts will not be suppressed between interactions occurring between different PowerPlans or orders existing on the profile outside of a PowerPlan. Only select PowerPlans are included for suppression.

Repeat numbers in duplication therapy
Duplicate therapy alerts for stimulant and hyperosmotic laxatives will be suppressed for the first two orders placed. Once a 3rd stimulant and hyperosmotic laxative is ordered, the user will start seeing the duplicate therapy alerts. No alert will fire in the background with a system suppressed override reason.

Venue of care filtering
Suppression of drug-drug, drug-allergy and duplicate therapy alerts when converting medications between home medications to inpatient orders. Alerts between inpatients orders will continue to display.

Scheduled vs PRN filtering
Suppress duplicate therapy alerts between interacting orders when one has a scheduled frequency and one has a PRN frequency and the medications include: albuterol, ipratropium-albuterol, levalbuterol, fluticasone-salmeterol, budesonide-formoterol, mometasone-formoterol, arformoterol, fluticasone-vilanterol, tiotropium-olodaterol, tiotropium, umeclidinium-vilanterol, salmeterol, or ipratropium.

The Great Lakes Integrated Medical Record

Our mission to improve health outcomes for the communities we serve by creating a best-in-class, clinician-led, patient-focused, fully integrated electronic medical record (EMR) is founded on two pillars: optimization of the existing EMR that’s currently in use throughout the Kaleida Health system, and, integration of our Great Lakes Health Community Link partners into the same state-of-the-art patient medical record. 

By the end of this multi-phase, multi-year project, we will have a single, unified, community-wide electronic medical record. Not only will the EMR experience be nearly identical for all parties, but the EMR will be interoperable and system-wide. It will deliver real-time patient data from anywhere in the system to anywhere in the system.

In the spirit of unity and collaboration, the Executive Sponsor Steering Committee representing all the stakeholders involved in this massive undertaking have decided unanimously to rename the EMR and its associated pillars the Great Lakes Integrated Medical Record, or GLIMR, for short. 

We have rebranded the two pillars of the GLIMR project: What was formerly called “EMR Optimization” is now GLIMR Advance; the former “CommunityLink” is now known as GLIMR Expand.

According to the old adage, there is strength in unity. GLIMR is not solely an IT project. It’s about moving beyond silos to a genuinely unified health system. It’s about how we take care of our community together. 

For more information, follow the monthly GLIMR newsletter on the KaleidaScope EMR Investment page