Extend the Value of Picis ED PulseCheck in the Emergency Department

How long does it take to report your AMI, HF, and Pneumonia Core Measures in the ED? If your answer is weeks or months, you’re like the majority of hospitals in this country. Why? Because you’re overburdened with chart abstraction, free-text/unstructured documentation analysis, and what I like to call, “manual process fatigue”. That’s ok though, because some hospitals have started making progress automating their ED processes with applications like Picis’ ED PulseCheck. Deciding to evolve from a paper-based to electronic system in your ED is the easy part; implementing an ED Information System can be much more difficult (I know I know…”thanks Captain Obvious”). There are steps, though, that can make your journey much smoother.

There are ways to extend the value of an application like ED PulseCheck from the very beginning. It is a great application for integrating charge capture and the clinical documentation necessary for full reimbursement; it’s interoperable with other hospital systems; it’s ARRA compliant; the list goes on. Aside from the out of the box functionality, there are ways to morph this type of application into a larger asset than most Picis clients even consider. One example relates to Core Measure compliance. As I mentioned in my opening, the average hospital will report August 2010 Core Measure compliance sometime in October or November (when will you?). This is because it takes teams of people countless hours to sift through any number of paper or scanned documents and free-text narrative clinical documentation to identify the words and phrases necessary to satisfy the stringent CMS requirements. If you want to drastically reduce the timeframe to report Core Measures start by considering these and other reporting requirements when you first implement, upgrade, or extend your EDIS. One more advantage to an application like Picis ED PulseCheck is the fact that it is malleable and can be easily customized to the user’s needs. I’ve helped customize the tool to embed the exact language CMS expects for Core Measure compliance right at the point of data entry so your clinical staff is not responsible for memorizing the CMS rules, especially because they change twice a year. Removing this burden improves your compliance and in addition, wins over the staff by reducing the time spent documenting their care. Instead of continuing to allow unstructured data entry in that Picis memo field, create a drop down menu of available options for what the clinician should be documenting aligned with CMS standards. One example we delivered to an IDN in the southwest was a drop down list of antibiotics included in their pharmacy that met the requirements of the PN-5 measure for antibiotic timing. In this way, the clinicians could discretely document the drug given, no manual written or typed entry was necessary, and the nurse abstractors could simply run a query that monitored the field for the right antibiotic administered, along with the date/time field of administration and the date/time field of when the patient arrived, to ensure compliance with the 6 hour mandate.

How are you extending the value of ED PulseCheck in your hospital? I’ll collect the stories and feedback I get and post a response to this blog at a later date.

Ryan Hayden
Principal Consultant
Email: rhayden@edgewater.com

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