Integrate Unstructured Health Information with HL7 and ECM

As interoperability continues to be a focus, healthcare organizations are able to integrate more and more health information and records directly into the Electronic Medical Record (EMR). However, patients often still bring with them a huge amount of physical records and documents that are critical to their care. This means healthcare organizations must also find innovative ways to integrate unstructured content like external records into the EMR.

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Pitts P.:
Welcome to Webinar Wednesdays at RPI. Thank you for joining the Healthcare Solutions and Integrations with ECM. Webinar Wednesdays is our new webinar series hosted every first Wednesday of the month here at RPI. A few housekeeping items before we get started. The webinar will be recorded and shared on our blog and on our YouTube channel in a few days. For those of you dialing in today, the slide deck will be shared via email immediately following this webinar. We also have a moderator standing by to take your questions, so please feel free to submit those to the GoToWebinar interface. If you have any questions, or additional webinar topics, or something you’d like to see presented, please let us know.

As I mentioned, it is Webinar Wednesdays. Shortly after this at 1:00 join us for another webinar about our new Yoga updates. Again, that’s our lightweight web client for ImageNow. Then later at 3:00 Abbey and Derreck will be going over the technical and solution health check offerings that we have. The next webinars are scheduled for May 2nd. There you can expect our webinar over at the Outlook client with OnBase, an overview of the Kofax products and solutions, and then some of our project coordinators will be talking about planning your next upgrade. As I said, my name is Pitts. I’m a Senior Solutions Architect here at RPI. I have about six years of experience with Perceptive Content, specifically within the healthcare space, and I love my dog Tofu.

Chris Tan:
My name is Chris Tan. I’m a Senior Consultant here at RPI Consultants. I have six plus years of experience with the Perceptive Content platform, primarily focused in the clinical healthcare space, and I am a husband and father of two. For today’s agenda, we’re going to give you a brief overview of RPI Consultants, discuss integration solutions for unstructured content, focus on healthcare workflows and solutions, do a quick products overview, and then end with a Q&A session.

At RPI Consultants, we are a comprehensive professional services organization with over 18 years of experience designing, implementing, and supporting ERP, ECM, and Advanced Data Capture Solutions. We have about 80 full-time employees based out of our office locations in Baltimore, Tampa, and Kansas City. We offer many different services and specialize in the product partnerships with companies such as Hyland, Kofax, and Infor.

Pitts P.:
All right. Integration solutions for unstructured content. Kind of coming off the HIMSS wave, interoperability in the HIER are proponent topics within the healthcare IT space. Integrating content is expensive, but very important to reducing costs, increasing your margins, and improving patient care. The challenges incorporating unstructured content into your system so that they’re visible and accessible to everyone. The EMR should kind of limit the central point of every health system and the ECM compliments that application by holding content and allowing for those content-driven workflows. Where we’re going to go over here is are the principles of any patient-centric healthcare solution.

Chris Tan:
We’ll start off with… we’ll discuss HL7 interfaces. HL7, or Health Level 7, is an interoperability specification for health and medical transactions. Our healthcare solutions are designed to receive inbound HL7 feed from the EMR, as well as generate outbound feed back to that EMR. Perceptive Content uses the core point integration engine to accomplish this while Hyland OnBase has built in functionality called the HL7 module.

We use HL7 to build and maintain a patient database within the ECM. That cover the creation and update and merging of patient medical records. Regardless of ECM in order maintain the integrity of your EHR or EMR the patient database is required in the ECM. During indexing, we’re associating documents to charts within the patient database as opposed to the EMR directly.

Pitts P.:
Now with the HL7 and the patient database in mind, what I wanted to go over was the base solution for using your ECM as a legal medical record. This is all centered around the document workflow. That can be summarized in three steps. The capture, indexing and retrieval.

So with capturing we can’t to bring documents into the system. Your ECM is going to integrate with your scanners and your MFDs for any physical document capture. Users could also upload their digital content via imports or virtual printers, or even through email. We do offer some automated capture points for those digital documents and this is typically done by monitoring directories, creating documents out of a HL7 feed, monitoring inboxes, and inbound fax lines as well for like a scheduling solution. The idea is to get everything into the system first and index, and then we can kind of route those documents as we need to.

As documents are captured, indexing is that process of tagging those key patient encounter metadata on to the documents to be filed into the patient’s chart. Indexing can be automated or manual as well. Some of the automated indexing options are capturing directly out of the EMR. As we capture documents straight from the EMR the patient context is passed to us so that those can be applied on to the documents immediately. Another method of automated indexing is using those barcodes. Typically, document patient encounter barcodes on those documents. Using an index file or even in some cases perform OCR of those documents to pull their metadata. A lot of documents are not going to be automatically indexed and the ECM provides these manual solutions for specialized indexing. Within the perceptive space this is typically done with patient indexing e-form or even some solutions within the experience platform and then OnBase is kind of built into their keyword sets.

As the documents are captured in index the next step is really retrieving them as their already filed. This is again is done really in two different ways. You can pull those documents out of the ECM directly using document and folder views or navigating through the chart within the ECM. That’s typically done with the HIM staff or users who aren’t typically working out of your EMR. For those users that work out of the EMR exclusively, either physicians or nurses, those documents are retrieved through specialized clients, all kind of related to that document ID and we’ll go over those clients here in a second.

With HL7 the patient database and document workflows in mind we wanted to show you how these are applied to real world workflows that you’ll find in a hospital or clinical setting.

Chris Tan:
So for scheduling solutions we built workflows to monitor fax queues to generate images that are indexed against our patient database. For registration and admitting solutions there’s a direct integration into the EMR where document like, photo ID or insurance card, are captured directly into the medical record at the point of service.

As typical with a HIM workflow, post-discharge patient charts are batch scanned and indexed into the ECM. In some cases barcodes are used to extract patient metadata and index against the patient database. These can also be used for document type identification as well as patient and encounter selection. For incorrectly index documents we have a records correction and misfiled document solution that allows HIM staff to re-index documents and automatically remove those document links from the EMR.

Pitts P.:
And kind of piggybacking off of the HIM workflows, after post-discharge, typically the coding and analysis workflow takes place and this is where ECM really shines. Because this is a very document centric workflow your HIM coders are able to look at this charge, submit those physician queries, bookmark chart documents as they’re needed and then they can route them forward to those analysis group. The analysis group is where users are submitting their deficiencies, routing those charts again as they need and addressing the request from the coders. Once those deficiencies are assigned to the physicians, the physicians can complete those deficiencies all through the ECM. They can complete them, reject them, reroute them, there’s even proxy functionality that allows other users to sign in the case of their absence.

Chart deficiency tracking is a specialized solution that’s really task based. For example with the Perceptive and Epic integration the tasks are created w