1. EMR-LINK A Fall 2010 Review

2. Housekeeping 1.Shrinking the GTM session 2.Being muted. Your Audio Pin Raising hands. 3.Well have breaks for questions. 4.Use Chat to queue up questions.

3. What Well Cover Today Whats new with orders? Auto-splitting Courtesy copies Billing interface EMR-Link 2.0 (well, its not so new any longer) Whats new with results? Always copy this user….. Send results to my HIE too…. New products PDF download HIE Connect Adding a second lab (and the three possible levels) Adding radiology orders Maintenance tips When your lab changes an order code Where to find help

4. Clinics EMR-LINK Account Services The Whole Picture Lab Clinics EMR LinkLogic Order Entry Questions Requisition printing ABN printing Label printing Radiology Meds Lab Requisitioning Database Rules-based routing (insurance and location) Clinic specific mapping of EMR-to-Lab data Point-of-care ABN Validation (Uses labs ABN rules) Manifest Reports Future Orders Billing interface back to PM (future) Auto-Completion Provider desktop notification Clinics mapping tablesRequisition Completion LIS ABN Validation HL7 compliant ORM Complete order information to labs requirements HL7 compliant ORM Complete order information to labs requirements EMR-Link Connector Electronic (HL7) Result Lab Result Manager Secure HTTPS downloads 4 3 22 8 7 EMR-Link Connector EMR dataLab 1 DataLab 2 Data Provider NamesUPIN/NPI Order codesLab order codes InsuranceLab Insurance Location of CareLab account # Routing Rules (choose the lab) 5 Your Code EMR Order Codes 1 Lab 2 Lab 1 Lab compendiums 3 HL7 Order 6 Req Label

5. Clinics EMR-LINK Account Services The Billing Interface Lab Clinics EMR LinkLogic Order Entry Questions Requisition printing ABN printing Label printing Radiology Meds Lab Requisitioning Database Rules-based routing (insurance and location) Clinic specific mapping of EMR-to-Lab data Point-of-care ABN Validation (Uses labs ABN rules) Manifest Reports Future Orders Billing interface back to PM (future) Auto-Completion Provider desktop notification Clinics mapping tablesRequisition Completion LIS ABN Validation HL7 compliant ORM Complete order information to labs requirements HL7 compliant ORM Complete order information to labs requirements EMR-Link Connector Electronic (HL7) Result Lab Result Manager EMR-Link Connector EMR dataLab 1 DataLab 2 Data Provider NamesUPIN/NPI Order codesLab order codes InsuranceLab Insurance Location of CareLab account # Routing Rules (choose the lab) Your Code EMR Order Codes 1 Lab 2 Lab 1 Lab compendiums 3 HL7 Order Req Label 2 PMIS 4

6. Lab EMR-LINK Services Consolidation For The Practice Clinics EMR LinkLogic Radiology Meds Lab Orders Database Lab Orders Database Clinics mapping tablesOrder Completion EMR-Link Connector Electronic (HL7) Results Secure HTTPS downloads EMR-Link Connector Lab Result Manager Electronic (HL7) Order Lab Your EMR Order Codes EMRLab1Lab2Lab3 Provider s UPIN / NPI / EMRLogin Order codesTests Insurance LocationAcct # Routing Rules (choose the lab) ABN Validation

7. EMR-Link: Extensible Lab and EMR Connectivity EMR-Link Repositories (HIE or public) Reference Labs Hospital Labs Imaging Depts EMR Clinic 1 EMR Clinic 2 EMR Clinic 3 Labs with Bi- Directional Integration LabCorp Quest Bio-Reference CPL (Sonic) Mullins Providence PAML PeaceHealth Mercy Medical Cortland Labs with Bi- Directional Integration LabCorp Quest Bio-Reference CPL (Sonic) Mullins Providence PAML PeaceHealth Mercy Medical Cortland

8. EMR-to-Hospital Integration Orders Hospital Practice ECG PACS Lab Structured results URL link to image Link to reporting system Full text report LinkLogic Engine Orders hospital services Results review Lab results ECG reports/images Radiology results/images Hospital Benefits Competitive Outreach Services Increase Referrals to Departmental Services. Clean orders (decreases write-offs) Hospital Benefits Competitive Outreach Services Increase Referrals to Departmental Services. Clean orders (decreases write-offs) Practice Benefits Order reconciliation (auto-completion) Guaranteed chart matching Link to images (radiology) Practice Benefits Order reconciliation (auto-completion) Guaranteed chart matching Link to images (radiology) EMR-Link

9. Imaging Clinic Radiology Workflow Improvements Order Completion RIS EMR Chart Matching Physician Review Physician Ordering Results match to charts Desktop notification Updates the order status Easy to order ABN validated Patient ID Physician ID Order ID Pre-auth? Scheduling? Clinical lists AOE questions Minimize data entry PACS Contains link to the image study Reqd insurance Verified ABN No data entry

10. PDF Result Interfaces The lab report you already know now includes a link that references the PDF Enhanced view can include color, graphics, etc. Ideal for specialty labs You can add multiple PDF storage locations as needed. E.g., if you fill up one disk you can leave the current PDF files there and start a new data store elsewhere. Easy to install and configure. It only takes a few minutes more than a standard results kit. PDF storage is at the clinic so you have ownership of the data Works with all supported EMR releases except 5.6.

11. Clinics EMR-LINK Account Services PDF Results Flow Lab Clinics EMR LinkLogic Order Entry Questions Requisition printing ABN printing Label printing Radiology Meds Lab Requisitioning Database Rules-based routing (insurance and location) Clinic specific mapping of EMR-to-Lab data Point-of-care ABN Validation (Uses labs ABN rules) Clinics mapping tablesRequisition Completion LIS ABN Validation HL7 compliant ORM Complete order information to labs requirements HL7 compliant ORM Complete order information to labs requirements EMR-Link Connector Electronic (HL7) Result With PDF Lab Result Manager 3 EMR dataLab 1 DataLab 2 Data Provider NamesUPIN/NPI Order codesLab order codes InsuranceLab Insurance Location of CareLab account # Routing Rules (choose the lab) PDF File Store 1 Lab 2 Lab 1 Lab compendiums HL7 Order 2 Your EMR Order Codes Link to PDF 4

12. Health Information Exchanges Health information exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system.

13. Health Information Exchanges

15. EMR-Link: Extensible Lab and EMR Connectivity EMR-Link Repositories (HIE or public) Reference Labs Hospital Labs Imaging Depts EMR Clinic 1 EMR Clinic 2 EMR Clinic 3 Labs with Bi- Directional Integration LabCorp Quest Bio-Reference CPL (Sonic) Mullins Providence PAML PeaceHealth Mercy Medical Cortland Labs with Bi- Directional Integration LabCorp Quest Bio-Reference CPL (Sonic) Mullins Providence PAML PeaceHealth Mercy Medical Cortland

16. Alliance of Chicago deploys EMRs at community health centers across the US Theyve standardized on Ignis for all lab and imaging integration. Theyve seen improvements here…….. Implementation Times Improve Setup and TestPrevious Time Reqd Time with Ignis Tools Load Test Library80 hours4 hours Drs Custom Lists24 hours8 hours Panels16 hours4 hours Load Libraries 80 hours Custom Lists 24 hours Panels 16 hours 484 From 120 hours … to 16 hours

17. EMR Orders Builder Automating The Setup: The Orders Builder EMRLab Utilization Reports Orders BuilderEMR Clinical Kits Builds your order categories (or maps the ones you already have) Builds your custom order lists

18. The Lab Results Builder Builds your EMR flow-sheet Builds your cross reference (xref) from lab codes to EMR flow-sheet observation terms (or evaluates the one you have already)

19. Questions and Discussion

20. In Closing Provider and practice workflow is job 1 We automate setup We automate maintenance Well keep you up to date (monthly release notes) We give you tools for your job (ROI worksheet) Contact us any time www.emr-link.com www.emr-link.com

21. Thank You! Pat Wolfram

22. Services Results Only Dataflow Lab Clinics EMR LinkLogic Radiology Meds Lab Order Codes LIS Paper Lab Order Lab Results EMR-Link Connector Electronic (HL7) Result Result Manager Secure HTTPS downloads Clinics EMRLINK Account Uniform and Secure Download Mechanism for the Clinic Download method for one lab or many labs Uniform Distribution Mechanism for Labs Establishes EMR-Link framework for adding Lab Orders. Queues results for the clinic Responds to HTTPS requests for downloads.

23. Comparing Lab Orders…. Centricity EMR 9.2 And EMR-Link

24. Services The Benefits of Centricity 9.2 HL7 ORM and assisted order completion. Lab Clinics EMR LinkLogic Radiology Meds Lab Order Codes LIS Lab Orders Lab Results HL7 compliant ORM Patient ID Provider ID HL7 compliant ORM Patient ID Provider ID 1. ORM complies with the HL7 ORM orders message needed by the labs. 2. Patient ID in the order guarantees a match to the patients chart when the result is returned. 3. Narrows the choices of orders for manual complete

25. Services EMR-Link adds the following to 9.2 Lab Clinics EMR LinkLogic Radiology Meds Lab Order Codes LIS Lab Results Order completion EMR dataLab Data Provider NamesUPIN/NPI Order codesLab order codes InsuranceLab Insurance Location of CareLab account # ABN Validation Lab Orders Orders database Orders database HL7 compliant ORM Patient ID Provider ID HL7 compliant ORM Patient ID Provider ID Clinics mapping tables Billing decisions are made. Test specific (AOE) Order Entry Questions Requisition printing ABN printing Label printing Billing decisions are made. Test specific (AOE) Order Entry Questions Requisition printing ABN printing Label printing Rules-based routing (insurance and location) Clinic specific mapping of EMR-to-Lab data Rules-based routing (insurance and location) Clinic specific mapping of EMR-to-Lab data Point-of-care ABN Validation (Uses labs ABN rules) Manifest Reports Future Orders Billing messages sent to clinics PM. Manifest Reports Future Orders Billing messages sent to clinics PM. Auto-Completion Dr. Desktop Notification Auto-Completion Dr. Desktop Notification 42 6 5 3 1

26. The Difference…… with EMR-Link you get 9.2 ORM support and. 1. Point of care ABN validation. EMR-Link informs the provider at the point of care that a lab test is medically necessary based on CRM (Medicare)s ABN rules. 2. Rules based routing. EMR-Link routes your lab tests to the appropriate lab service provider, based on the patients insurance and your location of care preferences. 3. Support for UPIN or NPI. The providers UPIN or NPI number is inserted into the order. Also, once the lab is chosen, EMR-Link inserts the correct order codes for that lab, the correct insurance codes, and the account number for that lab. 4. Requisition completion --- with minimal manual entry of order data. No manual entry of data by your nurse or phlebotomist. Insurance rules decide if billing is to the 3 rd party (insurance company), client (bill to the clinic), or to the patient. Required test specific AOE (ask at order entry) questions are asked Requisitions to the labs specifications are printed Labels are printed for specimen containers ABNs, when needed, are printed. 5. Manifest Reporting : The EMR-Link lab orders database provides Downloadable manifest reporting includes: patient, test ordered, chosen lab, billing type chosen, insurance, Patient Service Center orders, ….etc. Future orders are stored here until the patient returns for the specimen collection, triggering the Order Completion process. HL7 billing messages are returned to the practices PM based on insurance or lab chosen. 6. Auto-Completion of Orders. Returned lab results are processed with the initial lab orders information. EMR test IDs are inserted into the ORU result, enabling Centricity EMRs auto-completion machinery. Upon signing of the result, the specific tests will auto-complete. The ordering providers UPIN (or NPI) is converted to their EMR login. This ensures desktop notification to the ordering provider.

27. Data Flow for PDF Downloads Lab EMR-LINK Centricity EMR LinkLogic Patients Chart Providers Desktop HTTPS Electronic (HL7) Order EMR-Link Database EMR-Link Database EMR-Link Connector Result Manager: Receive lab result and encoded PDF Insert original EMR order ID Insert ordering provider Send PDF to Clinic file store Send ORU to EMR Send MDM to EMR Result Manager: Receive lab result and encoded PDF Insert original EMR order ID Insert ordering provider Send PDF to Clinic file store Send ORU to EMR Send MDM to EMR ORU Message MDM Message With PDF Reference Clinics PDF File store ABN Validation Electronic (HL7) Result With embedded PDF PDF File