HealthyData Blog | Extract Systems

There's more than one letter?

If your letter is from the United Network for Organ Sharing (UNOS), it will most likely be from the UNOS Membership and Professional Standards Committee (MPSC) after it performed a review of your center's data.  The MPSC will have flagged your program due to either functional inactivity (a failure to perform a transplant every 3 months, or in the case of pancreas, one every 6 months) or due to outcomes that are below expected results.  If the issue is a volume issue, you will be asked to document how your center is trying to increase the activity as well as what are your surgeons and physicians are doing to maintain their skills in the operative and medical management of the organs in question.  You will also be asked to justify the turn down codes for the organ offers you have received.  Should the issue be one of outcomes, you will be asked to provide synopses of the cases in question and include an analysis of what led to the below expected outcome results.  In addition, you will likely receive a Transplant Outcomes questionnaire that probes the experience of the surgeons, transplant physicians and administrator at the program as well as the extent of institutional support and commitment both from hospital leadership as well as from ancillary services and multi-disciplinary participation.  An activity log will be provided to assess how many patients are evaluated, listed and transplanted at the center.  Depending upon the situation, MPSC may request follow-up reviews to monitor the program's progress. 

Clinical data abstraction is often one of the last steps in the patient care information workflow.  Typically it's performed for the sole purpose of submitting data to compliance or quality improvement measurement programs.

What if you were able to perform data abstraction immediately upon receiving medical records from outside providers (labs, diagnostic test centers, pathologists, etc...) and capture the data in the designated, structured EMR data fields before patient care begins?

Would having that information in discrete fields in the EMR from the very beginning of the patient's journey be helpful and might it have a positive effect upon the overall quality of care?

Recently, Andy Slavitt, the CMS acting administrator, announced that CMS will likely end the Meaningful Use program this year.

Does that mean that the hopes of an internetworked healthcare system that’s able to seamlessly share health information are completely dashed before interoperability truly got off the ground?

The answer to that question remains to be seen.

There’s no question that users rely on the EMR In Basket for day-to-day workflow management. The “In Basket” or “Inbox,” depending on what EMR you’re using, provides a centralized location to receive notifications and important patient information, such as admission and discharge notifications, new lab results, refill requests, patient calls, appointment reminders, patient portal communication and much more.

Do you frequently find yourself searching for and routing documents, whether paper or electronic, to colleagues, care team members or departments that need them?  Or, worse do you find yourself waiting for documents to be routed to you?  In our work, helping hospitals to automate clinical data abstraction, we're struck by the hours of time lost each day to inefficient workflows involving "loose" records that we often find ourselves helping our customers extract data from.

These are routine tasks that you may not even be aware of because they are taken for granted as "the way we've always done it."  

If you've ever managed an EMR data conversion, you likely know how painful data conversions can be. They require someone with intimate knowledge of the old EMR to write complex queries to extract the data in the format that the new EMR requires it to be in. In addition, at some point in the process you have to transform the old values into the new system's values (assuming they can be mapped at all!). Even if you have experienced, intelligent people and excellent vendor support during this process it is expensive, time-consuming, risky, and can delay your go-live. So, what if you don't have experienced people and good vendor support for your healthcare data conversion? Believe me, it's gonna get ugly.

Critical results reporting or reporting lab results for priority patients from non-interfaced sources is no easy task. A delay in reporting can yield an unfortunate outcome for a patient whose condition is deteriorating. This is especially true for specialty departments that provide continued care for patients from far-flung locales, such as the transplant program. One transplant department receives thousands of these reports over a single patient's lifetime, and often hundreds of these documents for its patient population each day by fax.

Until now, critical results management solutions have ignored the chore of sifting through these unstructured documents to report results to the care team. Consequently, handling these results has stubbornly remained a manual, cumbersome and error-prone process.

Extract Systems has developed a solution that not only automatically identifies lab reports for priority patients upon arrival. It also extracts and posts the data into the patient's EMR — a task that typically falls on the shoulders of thinly stretched staff.

What does the data mean and how can it be used?

Previously we have spoken about the importance of maintaining compliance and having an effective pre-transplant evaluation process to manage the influx of patients from your successful outreach program. Once patients are transplanted you must be persistent in your diligence to ensure successful outcomes. Sometimes, despite optimal efforts, you may experience bad outcomes. If these unfavorable outcomes reach a certain threshold, regulatory agencies will scrutinize your program. Our next series of blogs will discuss the triggers that bring your program under scrutiny, the preliminary inquiries that are made, your options and the transplant System Improvement Agreement (SIA) process.

What I know for Sure:

Discrete, trendable data is the bread and butter of a specialty clinic.
Hunting and pecking through the media tab to track down information on a patient is infuriating! And not only for the doctors. For nurses. For abstractors. For the patient! Trending a post-transplant patient's drug levels alongside their medication doses, rejections, infections, transplant history, UNOS data, procedures, and relevant transplant-related scores is of paramount importance to a clinician and is very time sensitive. Getting all patient data into the EMR is the holy grail when it comes to specialty medicine.

With the final days of 2015 upon us, I would like to thank Extract’s customers and colleagues for your support and engagement this year. It’s been a significant year for our company which I’ll boil down by sharing two exciting milestones:

• Our solutions auto-captured more than 5 million lab test components for our customers. This number has grown exponentially and that growth will continue in 2016.
• We developed a Pathology data extraction solution that captures more than 400 fields from pathology reports across 8 different disciplines and converts unstructured data into relevant, discrete information for research.

I’m inspired by our customers’ passion for pursuing better patient outcomes while constantly looking for new ways to reduce the cost of healthcare delivery in this country. Nearly every day I notice anew how our accomplishments are tied to our customers’ drive for innovation. I’m grateful for their willingness to share their stories and reveal healthcare data gaps.