7 Phases for Successful Epic Beaker Project Planning

7 Phases for Successful Epic Beaker Project Planning

Spring has arrived and for many laboratories that means planning is underway for new LIS projects. If a roll out of a new LIS system is something your team is tackling, here is an outline of 7 project phases our Beaker certified staff of licensed Medical Technologists (MT) believe to be critical parts of a successful plan.  Following all the steps and phases will help you achieve your goal, ensure the needs of your lab are met, and ensure patient safety.

1: Planning – Application Coordinator and Application Manager have onsite visit from Epic team to evaluate the lab department.

Key points: Make sure all software and technical aspects of the lab are included:  Blood Bank, Anatomic Pathology, Laboratory Automation System, and Analyzer Instruments.

2: Installation – Shell System is installed as a Basic Foundation System including build of all lab tests.

Key point: Your lab team can provide a complete list of all order codes and tests available, including all reference lab tests.  This will help you to avoid delays and manually needing to build them later on.

3: Validation – Usually a 3 month time period consisting of site visits to go through lab workflow and determine customization requirements.

Key point:  Ensure Subject Matter Experts (SME) from each department are included for decision making. 

ü  Clerical/Billing

ü  Chemistry

ü  Specimen Processing

ü  Hematology

ü  Microbiology

ü  Blood Bank

ü  Urinalysis

ü  Pathology

 4: BuildBeaker Build occurs in a 3-4 month period concurrent with all other system builds.

Key Point: Many detailed build items occur during this phase.  Some items will be completed by IT personnel and other by laboratory assigned resources.  Experience and clinical knowledge are critical at this step.  Include your Beaker Certified MT or MLT in all aspects of the build, their clinical knowledge is invaluable to completing a full lab build and have it done right prior to the MRT testing period. 

·   Order Codes and Test Codes – Only the initial build is done via export/import functionality so be sure to assign each department SME their section to validate.

§  Facility Structure Build – The full lab and department outline will be detailed here. Include your specimen routing logic, auto cancel rule, and worklists for bench development.

§  Instruments – All analyzer setup occurs here and mapping may be completed by an IT resource, but a MT or MLT should review and sign-off on all data.  Laboratory staff should determine if processing rules will be written in the middleware selected or built in the application.

§  QC Build – A Unity Real Time external product or Beaker internal QC functions can be used for this build, but a department SME should work to develop the scheduled QC runs and alerts within system.

§  Security Build (outside Epic Beaker Module) –Having a certified resource assigned to build all lab users, allows control as to which lab facilities your end users will have access to.

§  Charge Build (outside Epic Beaker Module) – Laboratory build of CPT per order code or result code. Be sure to include a billing specialist to complete this build.  (BCS has developed a detailed billing testing plan that can be incorporated in your system validation to monitor accuracy.)

§  Patient Reports & Labels – Extra time and attention should be dedicated to make sure all CLIA and CAP reporting features are included for proper specimen or patient identification prior to reporting. 

§  Reference Lab Interface – Completed primarily by using translation tables which may be managed by the IT department. Again, include your specimen processing specialist for review and sign off of actual naming mapping and specimen mapping.

§  Custom Management Report Writing – This can be a very technical skill but laboratory personal need to provide the guidance on what they need to capture. 

§  Outreach EMR Interfaces – All outreach systems need to be validated against the new LIS Order and Test build to ensure translation tables are built with the new codes.

5: Testing (Mapped Record Testing) – Internal MRT process within Beaker. Each Order code is ordered and downloaded to the analyzers. Review results returned to ensure each posts to the representative result code. Include MRT to Reference Lab interface and EMR Interfaces.

Key Point:  MRT testing does not cover all CAP mandated checks to ensure laboratory results are complete and compliant.   Work with your project manager to add extra steps in your project plan that check for the following CAP regulations:

ü  Patient Name & Unique Identifier

ü  Name & Address of Testing Lab

ü  Name of Test Performed

ü  Test Report Date

ü  Physician of Record or Ordering Person

ü  Test Results Including Units & Interpretation (if applicable)

*If applicable/appropriate: Specimen Source, Specimen Comments, Date/Time of Specimen Collection, Time of Release of Report, Reference Ranges

6: Training – Workflows are developed by the Instructional Designer to train internal staff.

Key Point:  Include audit tracking to ensure all staff completes training and are signed off as compliant. Strong SOPs will help ensure processes are followed, and new personnel are trained properly.

7: Data Conversion – At this point, your old LIS is able to be exported and imported to Beaker for reference.  There is no limit to the amount of data that can be imported.

Key Point:  Have MT involved in linking each test/result from the old system to the new Beaker code.

After completing these 7 project phases, it’s time to take a deep breath and realize that your lab has gone live with Epic. Congratulations!  Our team has worked through these phases numerous times with Epic and Beaker, as well as with Epic and other Laboratory Systems, having seen firsthand how good planning and qualified resources can impact not only the build, but reduce the risk of retests and lost revenue. Carefully executing these 7 phases will help your new system work for your lab and your patients. Please call us for more information or help with any part of your project.  We’d love to help!

(480) 346-7011   www.bcsolutionsrfn.com

HIMSS 2016 Conference – Las Vegas

 Join us for a game of 52 card pick-up

HHIMSS-2016IMSS 2016 is just two weeks away.  Time to start planning which educational sessions, networking events and vendor exhibits you want to visit.  Each day will be packed full with things to do, not to mention…those Las Vegas nights!  Keeping your energy up will be important, so we’d like to play a little game of 52 card pick up…to help pick you up.  #52cardpickYOUup

Look for these cards while you’re at #HIMSS16. Find one and we will #52cardpickYOUup with a $10 Starbucks gift card.

Our team will scatter a deck of cards throughout the conference.  You never know where you’ll find one, or who might pass one your way.  Once you hold the card, just tweet a picture of it to @BCSolutionsAZ #HIMSS16 and we’ll get you a $10 Starbucks gift card to help pick you up and keep you going.

We are looking forward to the week at HIMSS, and hope that what happens in Vegas this time is taken all over the world to help educate and improve Health Care for everyone.

BC Solutions, LLC.  – Experts in Laboratory Information Systems. Bringing Clinical Knowledge, Compliance, and focus on Patient Safety to your next project.


Trying to solve the puzzle of LIS Compliance? Learn the Steps to Achieve Compliance.

It is critical to properly implement Laboratory Information Systems not just from an information technology perspective but with a clear vision of creating a safe and compliant interaction with all other hospital systems.   To achieve that goal, the expertise of IT specialists must be complemented by the experience of clinical professionals.  This helps create a system that not only complies with the letter of the law, but also fulling integrates the Laboratory while improving patient safety, ordering, results, and billing.

BC Solutions has compiled and presented current regulations and recommendations by the agencies tasked with governing this section of the healthcare industry. The goal is to provide a roadmap that can be used by all levels of your implementation team, regardless of their level of laboratory or compliance experience.  This common understanding of who the stakeholders are, what governing bodies are involved, as well as what steps should be taken to achieve compliance can be the difference between having a fully integrated functioning system rather than a stand-alone software implementation.

Download our white paper, Understanding Laboratory Information Systems Compliance here:  http://www.bcsolutionsrfn.com/white-papers


Planning for the new Cerner 2015.01 Version Upgrade

Cerner has released a major upgrade for 2015.  Specific changes to the PathNet Blood Bank Transfusion system promise an updated display, style, color palette and user interface patterns.  In addition to changes on how blood products are ordered, crossmatch warnings and exception reports will also be updated.

Specialists in Cerner validation, BC Solutions has developed a unique methodology that reduces the total validation testing time by 50-60%.  Our team of validation experts has proven to be best in the industry.  With decades of clinical laboratory and blood banking experience on our team, we target high risk areas in our testing protocols to ensure patient safety and blood safety requirements are met.  With a BC Solutions validation, your system will be audit ready with clear and compliant documentation.

Visit the Blood Bank Validation page on our website ( www.bcsolutionsrfn.com/blood-bank-validation ) for more information about the R.F. Nozick Validation Program as well as what is included in a Cerner Millennium Pathnet Blood Bank Transfusion Validation.

Contact us for additional information and find out how to add our experts to your team!

Will Nanotechnology Make Us Immortal?

Nanotechnology the Future of MedicineIn 2009, futurist Ray Kurzweil made the bold statement that by 2040, human beings could be close to achieving immortality through the use of nanotechnology. Well, here we are five years later and we’re not sure how much closer we are to being immortal, but certainly the use of nanotechnology and nanoparticles in the field of medicine has increased and many advances have been made.

Any time you hear talk of nanotechnology in the field of medicine (referred to as nanomedicine), it almost always conjures up images of microscopic robots running around inside you and fixing up tissue and organs that are in disrepair. But what is it really?

Nanotechnology is basically the practice of manipulating matter at the atomic and molecular level. The research of nanotechnology has been applied to many different fields other than medicine, such as electronics, fabrication, textiles, optics, just to name a few. In fact, nanotechnology is regularly used in most of those industries and we interact with it almost everday.

With regards to the health care industry, the medical community has been able to utilize nanoparticles and nanomaterials for a variety of applications such as drug delivery, protein and peptide delivery, fighting cancer, antibiotic resistance, and many others.

Recently it seems drug delivery is providing especially promising results. As of May of this year, MIT researchers have been able to use nanoparticles to carry two drugs at once and then release them one at a time, providing a one-two punch in the battle against cancer and shrinking tumors. Although it’s only been tested in mice, the idea is that the first nanoparticle delivery disarms the defenses of the the cancer cell which allows the second drug delivery to attack the cell more effectively.

Imaging and visualization have been another big advantage of the this new technology, allowing doctors and surgeons to precisely target tumors without damaging healthy tissue in patients.

Yet another promising use of nanotechnology has allowed researchers at Rice University to ‘weld’ flesh together bypassing the need for stitches. Basically, surgeons can pour a small liquid that contains gold-coated nanoshells along the seam of a cut. An infrared laser is then traced along the seam essentially welding the two sides together.

Nanotechnology holds many keys to detecting, diagnosing, and treating diseases in the future. But there will be many regulatory and financial obstacles to overcome, as with the development of any new medicine or technology. While achieving immortality by 2040 may be a far-fetched concept, there is no doubt that nanotechnology and nanomedicine are providing much excitement and hope for the future.

Health Care IT Security

Health Care IT SecurityThe conditions in which health information may be used is established by the HIPAA Privacy Rule. The rule’s intention is to insure that patient information and data is only seen by those who actually need to see it. But these days, where information may be stored in many different places and on many different systems, adhering to these rules has become more and more challenging. IT system security breaches are becoming common place and in the end the responsibility lies with the covered entity or health care provider.

Part of the issue, according to health care IT security companies, is the perception of many health care organizations. A lot of smaller hospitals and practices think that since they don’t collect credit card numbers, they don’t need to invest in security for their IT systems. What they don’t realize is that personal data, particularly medical data, is a valuable commodity to hackers and that information can be sold or given to unscrupulous entities.

Another issue is the recent onset of newer technologies. The widespread integration of EHR systems in the health care industry is streamlining and making patient information more readily available to doctors and health institutions, but it’s also become a popular target for hackers.

Additionally, many vendors are developing apps to work with providers IT and EHR systems, but don’t take HIPPA concerns into consideration when developing the apps allowing hackers to easily subvert security and steal data.

Providers and vendors aren’t always at fault, however. When Windows recently ended it’s support for Windows XP, it created a security risk for any practice that accesses electronic Protected Health Information via that product. While these practices weren’t at fault for the risk created, it is their responsibility to upgrade their systems.

When security breaches occur, the cost is usually a lot more than just stolen information. Once they are discovered, laws require providers to notify anyone who may have been affected by the breach which, in turn, undermines patients trust in the health organization or vendor. If the lost information ends up being used maliciously, the provider is almost certain to be staring down the barrel of a lawsuit.

In the end health care security needs to be taken very seriously, regardless of the size or function of the organization. When working with outside vendors, providers need to vigilantly research and confirm the security of any IT system they will be using.

BC Solutions specializes in full-scale, clinical laboratory software system installation and management solutions. We offer a complete range of services for our clients because installed compliant systems are more than just testing and validation.

Addressing EHR Rollout Problems

EHR rolloutsTo say that there are certain people in the medical industry that are resistant to change, especially when it comes to technology, may be an understatement. But with new regulations and rules coming our way, many hospitals, doctors offices, and providers have been forced to upgrade and embrace new technology or pay the penalty. In addition to avoiding penalties, there are also cash incentives available to practices that upgrade to and meaningfully use electronic health records (EHRs). But are these incentives actually causing problems with EHR rollouts?

Let’s take, for example, a recent case that occurred at the Athens Regional Health System in Georgia in which the CEO resigned after an aggressive and rushed EHR rollout. Staff and clinician’s basically came to a ‘no confidence’ vote for the CEO after the rollout created medication errors, scheduling problems, misplaced orders, and general disorganization. Management then turned and placed the blame squarely on the their own IT department for not following proper decision making channels.

In another example, a Maine Medical Center is claiming their EHR rollout is partially to blame for a $13.4 million operating loss. Nurses cited a lack of training and stated they were unaware that they were responsible for charging patients for procedures and that they weren’t even trained on how to charge with the new system. Therefore the blame was on the company that installed the system, according to the medical center.

So as in any instance where things go wrong the question is always, who’s to blame? Is it the CEO who aggressively tries to implement new procedures trying to take advantage of cash incentives? Is it the staff that are resistant to change and fail to apply themselves during training? Is it the IT company that installs the system and is responsible for training team leaders and employees on how to use the new system?

In a large amount of these cases, the blame seems to go in a circle. The staff blames management, management blames IT, IT blames the staff. In the end, everyone is affected from the hospital or medical center losing money down to the patients who don’t receive the proper care.

But if we step back and look at the big picture, the truth is that everyone is partially to blame and everyone is responsible for righting the ship. Technology rollouts are not something anyone should take lightly and preparation is key to make sure everything goes smoothly. All the decision channels should be determined before an IT company even starts to implement changes.

While we have highlighted some of the problems with EHR rollouts, there have certainly been a number of success stories. Many providers have successfully implemented new systems and are benefiting from quicker access to patient data, easier methods of sharing information, and better ways to track costs and bill patients.

Delays in new regulations are giving providers more time to make changes and providers would be wise to take advantage of the extra time. Additional training for employees and better testing of systems before they are set in place can help insure a smooth EHR rollout and ultimately help provide better care for patients.

Special Medical Assistant Watson the Supercomputer

Watson IBM SupercomputerAccess to data in the medical profession is priceless. Technology advances are allowing doctors and providers to not only access data quicker, but also provides a huge increase in the amount of data there is to choose from. Things that used to take days or weeks to research can now be researched in minutes or hours for savvy medical practitioners. But what is on the horizon is even more amazing.

Meet Watson the supercomputer developed by IBM. Actually, more of an artificial intelligence system. Some of you may remember hearing about Watson when the supercomputer took on champions in the game of Jeopardy and won in 2011. To help win at Jeopardy, Watson was fed massive amounts of data from encyclopedias, dictionaries, news articles, literary works, just to name a few. Then, it was able to answer questions using natural language processing, information retrieval, and other techniques. Though this process, IBM found Watson was able to provide extremely accurate answers to questions, regardless of how the question was asked.

IBM quickly recognized that this type of system was perfect for healthcare. Watson’s ability to analyze huge volumes of data and reduce it down to critical decision points would obviously make it perfect for a clinical decision support system. Doctors or assistants could simply input symptoms and related factors, then Watson could make suggestions based on thousands upon thousands pieces of data it has stored from medical books, EMR data, clinical studies, journal articles, doctors notes and patient information.

In February of 2011, IBM employed the help of physicians at Columbia University to help identify critical issues in the field of medicine that Watson could assist with and University of Maryland to help determine the best way for Watson to interact with practitioners to provide the best assistance. By September of 2011, IBM and WellPoint partnered up to actually utilize Watson to start suggesting treatment options to doctors.

In 2012 Watson was sent to the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University for the supercomputer to increase its healthcare data and medical knowledge as well as help medical professionals in treating patients.

More recently, an electronic medical records company, Modernizing Medicine, will partner with Watson to provide an electronic medical assistant app called schEMA. Physicians submit questions about conditions and treatments and will receive responses and treatment suggestions within seconds with information pulled from Watson’s wealth of medical data.

The potential for use of supercomputers in the health care industry is significant. For example, in addition to suggesting options for treatment, Watson can submit treatment proposals to insurance companies and receive near-instant approval from managed-care companies which will allow doctors to proceed with treatments quicker and possibly save lives.

IBM has recently created a business unit around Watson to deliver cloud-based services to businesses in several industries and invested $100 million dollars to help application development based on Watson’s ‘cognitive’ functions. It’s not hard to imagine that other computer developers will soon join the supercomputer revolution which will ultimately greatly benefit the health care industry.

The Impact of the ICD-10 Delay

On Apr. 1st, President Obama signed a bill that included another year-long delay of implementing ICD-10-CM (The International Classification of Diseases, 10th Revision, Clinical Modification). While this may have come as a relief to those vendors having trouble getting organized for the release, it has also frustrated many that felt they would be prepared by the Oct. 1, 2014 deadline. It is the second delay for the release originally slated for 2013 but now set for Oct. 1, 2015.

The ICD-10 revisions are indeed much larger than the previous revisions with more than 68,000 diagnostic codes versus 13,000 found in the ICD-09 release. The revisions are designed to be more specific in identifying treatments, for example, including codes that specify left leg from right, which was not part of the ICD-09 revisions.

Of those that had made preparations for the 2014 deadline, many feel it may cost them in the long run since they have already made investments in training and business practices. Some feel it’s also an indication that the health care technology can’t keep up with the necessary steps to progress the health care industry.

“It is alarmingly clear that healthcare is operating in an environment where there is no penalty for not being able to keep pace with necessary steps and deadlines to move the industry forward,” says Ed Park, executive vice president and COO, athenahealth, in a recent article from healthcareitnews.com “Our system is already woefully behind in embracing technology to drive information quality, data exchange and efficiency, and delays like this only hinder us further.”

Others are taking the news in stride and feel the delay will give them time for extra training and better understanding of the new diagnostic codes.

Renée Monahan, vice president of revenue cycle at Conemaugh Health System states, “One thing the delay will create is additional ‘practice’ for our coders, as well as more time to assess areas of documentation improvement that can be addressed before final implementation.”

Still other think the delay declines the integrity of the program saying that it will be hard for leadership and physicians to take the program seriously because of the delays.

The delay of ICD-10 was tacked onto a temporary patch for the sustainable growth rate, which has dismayed almost everyone in the industry that feel there needs to be a permanent fix for the SGR.

Better Information, Better Health Care

Health Care IT is playing a pivotal role in improving the standards of health care. In the past, patients would have to rely on their primary care physician as their center for collecting all of their medical records, including lab results and information from other doctors and specialists. But often, when patients would change doctors, information would slip through the crack because of out-of-date systems and procedural break down. But new compliance laws and new health care technology are creating better ways of collecting and sharing information.

When you take into account all of the things that make up your medical history, it’s easy to understand why there is a need for more advance electronic record keeping. Your medical history, immunization history, laboratory results and medical imaging are all elements of your medical records. By enabling doctors easier access to this information through technology, doctors are able to make more accurate diagnosis and treatment plans thus improving health care. New technology will also allow doctors to easily share the information with all providers involved in your treatment.

Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) are two of the ways health care is improving. Because they are electronically stored, they can be accessed remotely and by many different sources. This is especially effective when addressing chronic conditions such as diabetes, heart disease, and asthma, just to name a few. By being electronically reminded of the timing of preventative services associated with chronic conditions, doctors are better prepared to advise patients on how to care for their conditions.

New health care technology is also enhancing the way patients can manage their own health care. There is even software available for patients to set up their own personal health record (PHRs) to act a central hub of information they have received from their doctors. The more patients are involved in managing their own care usually means better communication with the doctors, which results in better health care being delivered as a whole.

BC Solutions provides complete management and installation solutions for laboratory software systems, specializing in blood bank validation and compliance.