Medical/Dental Professionals

Information Technology

Cerner Performance Excellence (CPE) Go Live is September 10

Several Great Lakes Integrated Medical Record (GLIMR) initiatives collectively called Cerner Performance Excellence (CPE) are scheduled to go live on September 10, 2019. Follow the links below for more information about each of these solutions (Links on KaleidaScope must be accessed from a Kaleida Health computer or while connected to the Kaleida Health network):

  1. Sepsis Management and Rapid Response (Adult and Pediatric)
  2. Venous Thromboembolism (VTE) Prevention
  3. Palliative Care

A fourth CPE solution is scheduled to go live later this month: Transitions of Care and Readmission Prevention.

Kaleida Health Information Technology and Cerner will have a command center located on the Buffalo Niagara Medical Campus to assist staff at all sites during the transition (Tuesday, September 10 - Thursday, September 12). In addition, clinical educators, clinical informatics staff and EMR coaches will be providing at-the-elbow support.

Why Model Experience is so Important to the Success of the GLIMR Project

Cerner defines Model Experience as “a collection of strategic recommendations for leveraging HealtheIntent, Millennium and Care Aware solutions to achieve client goals.”

But what does that mean?

First, it does not mean that Cerner wants to replace Great Lakes Health System expertise; rather, the goal is to augment it.

The organizations within Great Lakes Health know what they want and where they want to go. Think of Model Experience as a set of directions for attaining those goals.

The recommendations used in Model Experience come from a variety of sources:

• Technology requirements based on experience with other successful implementations
• Individual standards from healthcare and technology authorities like AORN and HFMA
• Guidance from Cerner strategic councils such as the Surgeon Council and the Revenue Cycle Council
• Accredited medical colleges
• Regulatory requirements from sources like Meaningful Use and DNV GL
• Input from Cerner clients – especially those involved in continuous improvement

In short, recommendations are based on evidence, expertise and experience. They are data-driven, goal-oriented, incremental and ongoing. They come in the form of suggested workflows, capabilities, content and Key Performance Indicators (KPIs). And they adhere to a continuous advancement mindset and approach. That bears a little explanation.

Cerner has found that some healthcare partners implement a new solution or workflow and then settle in. While recommendations continue from Cerner, the healthcare partner remains satisfied with their successful initiative, and falls into a state of stasis. Recognizing they have fallen behind best practice, some healthcare organizations engage in a big one-time optimization push to get up to speed. Inevitably, however, the successfully completed optimization will lag behind the ongoing, evolving nature of health care and Cerner recommendations.

Continuous advancement brings structure, measurement and systematic improvement through a series of small cycles of improvement. This measured, structured journey much better reflects the dynamic nature of health care and electronic medical record innovations.

Ultimately, Model Experience helps achieve goals in the categories of quality, safety, satisfaction, financial performance, regulatory compliance, productivity and efficiency.

It can be challenging to alter established workflows, change the focus of a KPI that’s been tracked one way for a long time or abandon a report that has served its purpose well till now. However, to reflect the dynamic nature of health care and embrace a continuous advancement approach to the care we give our patients, it is imperative that we standardize under Model Experience.

Ultimately, variability in a system will lead to variability in outcomes and successes. As Great Lakes Health, we cannot afford or endorse variability.

For the First Time Ever, UB Medical Students Will Train in the EMR

Practicing documentation throughout their education is expected to have tremendous downstream benefits for students and the healthcare system

A unique partnership among the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Great Lakes Health System and Cerner means that medical students entering the Jacobs School this summer will be the first class in history to receive training in the electronic medical record (EMR) while still in school.

“This innovative partnership between Cerner and the Jacobs School will allow us to bring state-of-the-art informatics education to our learners,” said Peter Winkelstein, MD, vice president and chief medical informatics officer for Kaleida Health, chief medical informatics officer for UBMD and physician sponsor of the GLIMR Expand project.

Representatives from the school, Great Lakes Health and Cerner have been working together over the last few months to build out a new educational domain of Cerner PowerChart for the Jacobs School. This groundbreaking collaboration will allow medical students to practice documentation on simulated patients on an EMR identical to the one used in the UBMD clinical space.

“It will prepare students for their clinical experiences as they train in Great Lakes Health facilities, as well,” said Dr. Winkelstein.

“This is an example of how Great Lakes Health works to support the three-part mission of academic health centers to provide excellent clinical care, education and research.”

Beginning this school year, students will start practicing electronic documentation with the simplest of visit notes. They will progress to more sophisticated and nuanced uses of documentation and data interpretation over the course of their studies.

This kind of EMR training as a part of the medical curriculum is unprecedented at UB. It is rare among medical schools nationwide.

Earn CME Credit for EMR Coaching

Learn tips and tricks from the pros to streamline your workflow and save time in the EMR — in real time as you document, enter orders and ePrescribe in the EMR on your own computer.

Our EMR coaches are pleased to offer this added benefit to all of our Kaleida Health providers.

Call the Kaleida Health IT service desk at 859-7777, option 1, to schedule a one-on-one EMR coaching session today.

Criteria for receiving credit:

• 60 minutes of 1:1 uninterrupted coaching while you do your daily work in the EMR
• Completed checklist of topics covered during your session
• CME form signature

Mandatory EMR Provider Training Due September 30

The current phase of the GLIMR Advance project involves bringing another 500 providers up to the latest version of Workflow MPages — a tool that makes interactive, visually rich, consolidated views of real-time clinical information contained throughout the EMR easily accessible within PowerChart.

There is mandatory classroom Mpages through September for all providers who are not in a specialty optimized in Phase I or Phase II of GLIMR Advance.

If you are included in this round of training, you should have received notification via email with instructions for registering for training.

Data Migration Demystified

You have maintained a valuable record of your patients’ health, and you have strategic goals in terms of quality, safety and satisfaction centered on those health records. Data migration employs state-of-the-art tools to ensure that your critical data is available to you on time and in budget.

While data migration is a key component of the Great Lakes Integrated Medical Record (GLIMR) Expand project, it is not quite as broadly understood as the other solution work in the project. There are a number of reasons for that. Data migration means different things to different projects, and the scope and scale of a migration can vary widely from project to project.

Our Cerner consultants are working with the Great Lakes Health teams to select specific demographic and clinical data to be extracted from source systems at the General Physician, PC (GPPC), UBMD and ECMC clinics for import into the GLIMR system, while identifying and working around data from those clinics’ systems that might already be present within GLIMR.

At present the GLIMR Expand data migration team is using modified Millennium Foreign System Interface (FSI) tools and processes to migrate formatted data from legacy systems to GLIMR.

The typical path for a data migration project is to first establish a person-centric foundation via Master Person Index (MPI) analysis and design using person data from each legacy system, and comparing that index to GLIMR. Defining what MPI demographics need to be imported to GLIMR helps create a population that the clinical data can then attach to.

Design, build and testing efforts for data migration culminate in the validation and import of specific subsets of data. The remaining source system data is sent to an archive system. Subsets of data for migration are selected using both retention ranges (one year, three years, etc.) as well as defining specific groups of data to move based on result or document type. Mapping those data elements from the legacy systems to GLIMR, for each data set in scope, comprises the main build effort for a migration project.

GLIMR validation of the source system data that was defined and extracted is the testing event for each data set in a migration. It leads to approval for the final import process to a production domain, in preparation for the go-live event.

The archive vendor selection process at Kaleida Health is in progress. Any legacy system data that is not directly loaded into GLIMR will be available in this archive system, viewable via PowerChart MPage.

Addressing Gaps in Care to Maximize Population Health

Physicians and staff spend an average of 15 hours per week closing gaps in care and satisfying quality measures, while provider organizations spend an average of $45,000 per physician per year to satisfy their quality initiatives. This cost is expected to continue to grow due to the prevalence of value-based contracts. Accurate and timely data allows foresight into opportunities for process improvement to reduce the administrative and financial burden surrounding this process. Health plans and regulatory bodies set standards that at times overlap and alternately never intersect.

Giving providers better visibility to gaps in care, and reducing the effort required to manage them, is one of the key objectives of our deployment of population health technology. There are three foundational components to our strategy:

1. Give providers broader and more timely data about their patient population,
2. Make it easier to provide recommended care and
3. Supply easy-to-use analytics that track our progress.

Studies have shown that the patient visit is the optimal time for the care team to address gaps in care. To make it easier to identify and provide recommended care, an integrated electronic medical record aggregating data on patients from multiple health system sources into one centralized repository, such as HealtheRegistries, will allow the care team to review and update measures/expectations within their workflow. Clear and concise data and guidance on patient health status will allow providers and care teams to have a full picture of that patient’s health situation. This offers insight to the practitioner to take the appropriate steps to close gaps and provide next-step guidance to impact efficiency and provider value levels while maximizing population health outcomes and patient and provider satisfaction.

Registries and provider scorecards will be available to provide timely visibility to the quality measures for the provider’s population and provide easy access to provider performance against key care metrics. Support teams and care management interventions at key points along the care pathway will be crucial to achieving success and providing next-step guidance.