Columbia University Medical Center

CROWNing Achievements: Improvements Make EMR More User Friendly

stylized Columbia crownCROWN just got easier to use, thanks to teamwork on a series of initiatives released last month. ColumbiaDoctors and the CROWN team have been working to improve aspects of the system in response to a physician survey.

Lloyd Torres, MHA, director of health information management (HIM), said the improvements encompass several areas, including system performance updates, lab order enhancements, results and scanned documents released to the patient portal,  scanning improvements, and a CROWN access policy update. In addition, a CROWN upgrade to Allscripts TouchWorks 17.1 is planned for September. Below is a summary of key points around each of these enhancements.

System Performance Updates

Jessi Thomas, manager of information services, and her CROWN team, in collaboration with Allscripts, identified issues that bogged down the system, including background reporting and audit logging. With improvements on those issues, as well as an enhancement to our interface engine, CROWN is working more smoothly.

Lab Order Enhancements

Abiose Wilburg, CROWN project leader, and Kris Bhambhani, optimization specialist, collaborated with ColumbiaDoctors, the laboratory and NewYork-Presbyterian to ensure that lab results get to physicians quickly. The team identified issues with how orders entered CROWN were classified and described, and how lab samples were labeled. Previously, Torres said, “we sometimes didn’t have the right primary diagnoses because of EHR workflows, which caused billing issues that caused lab processing delays. We’ve tightened up and improved the methods by which diagnoses are captured for labs.”  The lab order job aide is here.

Results and Scanned Documents Released to the Patient Portal

This summer, ColumbiaDoctors is aligning with NYP and Cornell to mirror their release logic: After four calendar days, results are released to the portal. Sensitive tests like sexually transmitted infection (STI) results will continue to be kept off the portal. In the past, reports such as lab results and radiology findings were only released to the portal after physician verification. “However, it’s really more of a delay for patients as HIPAA allows them to readily get their results.”

Along with Christina Collette, IT project leader, the team has identified several high-demand scanned documents, which will be pushed to the patient portal, starting with school and camp forms.

Scanning Improvements

Classification problems and scanning accuracy issues also are being addressed.  Health information management specialist Amanda Linehan has worked with a vendor to help us put scanned documents into the right places in the chart. “In our initial pilot during the month of May with hematology/oncology, we had a 99.97% classification accuracy rate, compared with a historical rate of 60% to 80%,” Torres said.

CROWN Access Policy Update

In a joint effort with key stakeholders including Quality, Privacy, clinical departments, and IT, the application process for CROWN access for new staff members will be easier. With more drop-downs and streamlining, the electronic submission access form (eSAF) has been simplified and the team has developed an efficient, sensible workflow.

For physicians, the process is even more seamless; a feed from the physician credentialing system is delivered to the CROWN team to create access for anyone who is credentialed. Here is a copy of the Crown Access Policy.

CROWN Upgrade to Allscripts TouchWorks 17.1 in September

An upgrade of CROWN from Allscripts Touchworks 15.1 to version 17.1 will take place on Sept. 29. The after-hours upgrade contains 2015 Certified EHR Technology, which will position ColumbiaDoctors for Meaningful Use Stage 3 readiness.

This upgrade adds enhancements and new functionality, which are being tested and evaluated, and will be communicated and rolled out through the physician-led Clinical Health Information Technology Advisory group.

Worth a bookmark: The CROWN intranet page here provides a wealth of information on the system and is updated regularly.