Creating Assessments

Reworking existing paper assessments into a form that can be implemented digitally is a time-consuming task, but does not have to be a boring one. Using our EHR's capacity for creating assessments, with its ability to place all kinds of fields in different placements, using questions right off the MDS in some cases, putting logical rules in place to determine what is available at any given time depending on responses to previous questions - it's actually kinda fun. Being able to trigger Careplan interventions and goals based on responses to these questions, or scoring categories puts a smile on every RN's face.

Only a few diagram-based questions are available in our EHR - full body diagram, and a pain scale composed of cartoon faces. They told us that there is no other way to implement a diagram. Well.......

I went on the Net, and found this below:




I used some basic HTML tags to use this image as the Question, and added an interactive numeric scale field to capture the response.

The EHR Vendor loved it, and wanted to know how I did it.
The Corporate DON was not amused........ <laughing>

Hey..... ya gotta keep a sense of humor, even on a multi-million dollar project. Or.... ESPECIALLY on a multi-million dollar project.


Joseph Frank, CIO
Omni Health Systems of NJ
Avery Eisenreich, CEO

Leveraging email in the clinical workflow

Even though the EHR software has a communications module built-in, we are looking to introduce email in a much bigger way at the facilities, and one of the places we are looking at is nursing. It would be nice if nurses could be included in all the planned email notifications about admissions, transfers, discharges, or quick access to an initial documentation packet from a hospital admission prior to the patient entering the building.

The plan:

Setup a terminal at the nurses' station that would be accessed via group login, and there would be a group Exchange mailbox per station that all nurses would be able to monitor via Outlook open on their shared terminal. Obviously, they would have individual logins to the EHR, but to the machine/network/Exchange, they would all be grouped behind a shared login. I'm still not clear on how nurses would indicate to each other that they've processed an incoming email, or it still needs response etc

The problem:

I'm being told that this setup is a HIPAA violation for 2 reasons.

1) A nurse will typically visit a diagnostics/lab website, and save results down to the terminal's desktop or a network folder. Since there is no way to tell which of the nurses behind that group login subsequently looks at the file containing PHI, that constitutes a violation.  

2) Cannot tell which of the nurses is looking at the mail in the Exchange mailbox which might contain PHI as well.

My response:

Every one of those nurses grouped into a shared login/mailbox already has full access to the same PHI in the EHR itself. The only difference is that in the EHR, I can tell who logs in and out, but the scope of access is identical.

What do you think?

Joseph Frank, CIO

Omni Health Systems of NJ

Avery Eisenreich, CEO

Intro Post

As my organization (Omni Health Systems of NJ) begins its journey down the rocky road of EHR implementation, I thought it might be a good idea to keep a journal so that other souls sharing my personal potential purgatory might leverage any tip, tricks, and traps I pick up along the way to their benefit. Frankly, I'm hoping I'm the one learning something from any sparked and sparkling conversation that ensues.

So where are we now?

I'm in midst of an intense, month-long setup and configuration series of sessions with the vendor, a popular cloud-based EHR vendor for the LTC market. In addition, we are upgrading IT infrastructure in all of the 17 facilities we own and operate. I'm at the beginning of a major IT, software, process, and procedural transformation of facilities, and the organization as a whole.

Come friends, let us away.......


Joseph Frank, CIO

Omni Health Systems of NJ
Avery Eisenreich, CEO