I received excellent nursing care by caring and professional nurses.  This was very different from care I received 12 years ago while hospitalized. Unfortunately, not every patient has the same positive experience and outcomes. We still have a lot of work to do. Let’s celebrate our progress and commit every day to making improvements big and small that will move the delivery system to one with consistent, reliable care with minimal variation. One that allows our committed professionals to care for patients with tools that minimize administrative work.  At Lumetra Healthcare Solutions we continue to help customers reduce complexity and cost to make this vision a reality. Give us a call.

For additional information, please contact us at newbusiness@lumetrasolutions.com.

In collaboration with the City and County of San Francisco, Lumetra Healthcare Solutions has partnered with Barbary Coast Consulting and B&F Consulting to help guide Laguna Honda through this effort. Launched in December 2009, the LHS team is currently five months into the project. The assessment phase, which has consisted of working closely with staff, patients, and residents, with additional input from members of the wider community, designed to identify best practices and key areas for improvement at Laguna Honda, has just been completed. This collaborative learning process included one-on-one conversations between the LHS team and stakeholders throughout the Laguna Honda community, including management, patients, residents, and staff. “Discovery assignments,” that included focused conversations with patients, residents, and staff to deepen their understanding of what is experienced on a daily basis, were also developed for the Laguna Honda community. As a result of these discussions, every Laguna Honda unit and department has been asked to try one small, new approach designed to reduce stress, strengthen interdepartmental relationships, and increase the hospital’s ability to provide individualized care to their patients and residents. Units identified areas to work on from a list of possibilities, including these types of assignments:

• Paperwork reduction
• Building stronger ties between unit staff and social work, activities, and maintenance departments
• Improved clinical outcomes
• Utilization of consistent staff assignments
• Initiation of a “gentle awakening,” whereby residents can maintain their morning routine through a relaxed breakfast schedule.

While the results from this exercise are still being gathered, the early feedback indicates that the units are responding well to these changes and look forward to implementing many of them on a permanent basis.

Going forward, Lumetra Healthcare Solutions will continue to use this collaborative learning method to help Laguna Honda identify additional ways to maximize the opportunities and minimize the challenges offered by the new facility. Our progress will be closely monitored and measured, and — at the conclusion of the project — Laguna Honda’s roadmap for implementing the recommendations that are identified throughout this process will be documented. These recommendations will address staffing models, patient and resident care, employee satisfaction, community engagement, and the integration of technology. All of this work will build on the efforts already underway, taking great care to always put the needs of the patients and residents first. Lastly, the LHS team will work with Laguna Honda to develop easily usable tools to measure and report on the ongoing success of these outcomes, ensuring that the goals of the project are sustainable for the long term.

The consortium’s objectives are to inform a statewide plan, through regional experience, to:

• Increase provider adoption
• Increase payer provision of electronic eligibility, formulary, and medication history
• Increase pharmacy productivity, and
• Raise consumer and purchaser confidence and demand

Lumetra Healthcare Solutions will provide vendor-related coordination and information to the Consortium (www.calerx.org), to broaden adoption throughout California.

CalHIPSO is currently one of 32 Regional Extension Centers funded by the federal Office of the National Coordinator to support widespread adoption of electronic health records along with achievement of “meaningful use” of health IT to promote healthcare quality, safety, and efficiency within specific geographic areas across the nation. Although the definition of ‘meaningful use’ is still subject to debate, it is generally accepted to include the use of certified EHR technology in a manner that improves quality, safety, and efficiency of healthcare delivery, reduces healthcare disparities, engages patients and families, improves care coordination, improves population and public health, and ensures adequate privacy and security protections for personal health information.

Lumetra Healthcare Solutions (LHS), as a result of our pioneering work with the Doctor’s Office Quality – Information Technology project from 2003 to 2008 and the activities of our subsidiary, Illumisys (now a part of LHS), is in a unique position to offer services to physician offices in the planning, acquisition, implementation, and meaningful use of electronic health records (EHR). While the current focus on systems implementation is a necessary step in the process, it is important to understand and take the action needed to achieving implementation with meaningful use. This emphasis is designed to take advantage of those specific benefits afforded to physicians, staff, and patients during the course of leveraging new technology.

Our experience over the last six years gives us the ability to bring forward a strong toolset and experienced staff to help in addressing both revenue cycle management and EHR in physician office practices and other healthcare delivery settings. By offering a blend of in-office and long-distance assistance that is cost effective, yet meets the needs of each unique environment, Lumetra Healthcare Solutions looks forward to working with CalHIPSO and other organizations throughout the state to support the needs of physician offices in meeting eligibility for incentive funding and forging ahead with the adoption of EHR.

For additional information, please contact us at newbusiness@lumetrasolutions.com.

In making the announcement, the CEO of Lumetra Healthcare Solutions, Linda M. Sawyer, PhD, RN, stated, “With our software and services approach to improving patient safety, Lumetra PSO offers reporting of data, analysis of issues, and the formulation of corrective action plans that meet the needs of healthcare organizations and their providers in reducing costs incurred by adverse events. The combination of our world-class service with iSOFT’s AIMS software will provide unparalleled solutions for organizations committed to improving their patient safety efforts.”

Michael Dahlweid, iSOFT’s Chief Medical Officer, said, “AIMS is Web-based, secure, sophisticated, easy-to-use, and highly efficient. It uses the latest knowledge engineering methods to construct a high performance classification system. Its automated ‘alert’ and workflow functionality assures healthcare managers are notified about serious events, while providing follow-up notices to staff. Built-in Business Intelligence enables analysts extract meaningful information from a myriad of data points.”

The AIMS software provides an integrated electronic solution for collecting, tracking, reporting, and managing all patient safety activity. An incident and risk management software program, it provides specific and detailed reporting information needed to devise interventions and solutions to patient safety problems. The AIMS incident management software is based on 20 years of research and has been employed at more than 1000 organizations worldwide, including government healthcare agencies, hospitals, and nursing homes.

To meet the clinical, analytical, and technological patient safety needs for healthcare delivery systems, Lumetra PSO supplies software and services that include:

For healthcare organizations

• Common Formats seamlessly integrated with AIMS massive ontology (24,000 available concepts) developed by the Agency for Healthcare Research and Quality (AHRQ).
• Immediate analysis and alerts allowing local management of incidents and risk
• Comprehensive analytics for strategic reporting and benchmarking
• Root cause analysis
• Collaborative learning forums
• TeamSTEPPS™ Master Trainers and targeted interventions

For PSOs

• AIMS world-class, highly intuitive, Web-based software
• Regulatory compliance programs
• PSO member management services
• Scalable solutions for reporting and data analytics to meet a variety of needs beyond Common Formats

The Lumetra PSO provides several levels of comprehensive, confidential, and privileged services plus additional value-added consulting for healthcare providers seeking to understand and minimize their safety risks delivering patient care. The PSO’s expertise lies in analyzing the care delivered during patient safety events, including the identification, analysis, prevention, and reduction or elimination of the risks and hazards, as well as root cause analyses (RCA) and action plans for improvement. The collection and reporting of patient safety events in healthcare facilities is facilitated by the use of common definitions and reporting formats (Common Formats) developed by the federal Agency for Healthcare Research and Quality (AHRQ).

Results of the study will determine how and when eRx is rolled out to other safety net institutions here in California.

Lumetra Healthcare Solutions was charged with several tasks:

• Conducting workflow assessments prior to implementation.
• Offering technical assistance during implementation and system go live.
• Developing and capturing operational efficiency measures for the project.
• Measuring the return on investment of eRx for clinics and internal and independent pharmacies.

Nationally, the focus on eRx continues to increase and this project, as with others, has yielded some remarkable successes:

1. Volume of electronic prescriptions and user adoption has increased rapidly over a six-month period of time, providing value through the elimination of ‘legibility’ issues. Within two months of eRx adoption, approximately 1,500 e-prescriptions were transmitted weekly, and the e-prescription volume increased by as much as 75% over the next 3 months.
2. Crowded pharmacies and patient wait times for medications have been reduced, based on the rapid routing of eRx data, especially to the internal pharmacies of public hospitals.
3. Time has been saved for patients’ receiving refills due to the following:
4. Pharmacy callback time is decreased when a physician writes a script knowing which appropriate formulary medication will be covered.

• The ability to link the patient’s medication profile with their electronic medical record, thereby reducing the time needed to search for the patient’s chart and deliver it to the physician’s desk, and
• Minimizing the time needed for the physician to read through the chart to get to the appropriate area of the file.

Although the study is still ongoing, several ‘lessons learned’ and key recommendations have arisen:

1. Pharmacy involvement at a detailed level has been critical for success. In particular, the need to perform full cycle testing of eRx routing and understanding data transfer between the eRx and pharmacy systems is vital to a smooth transition. Pharmacist, physician, and staff input in workflow are crucial to building a system that is functional for the everyday staff.
2. Preparedness for transaction costs within internal pharmacies and those pharmacies associated with the 340b drug pricing program is critical in creating expectations for financial impact. In the case of public hospitals, one must assess the costs, both business and technical, of SureScripts routing versus other direct means of prescription routing, where an internal pharmacy is involved.
3. Coordinate with the software vendor so as to leverage system reports and metric tracking of target areas for rapid cycle improvement that may include everything from system configuration enhancement to additional user training.
4. Create an environment of open feedback and adaptation in order to refine the prescribing and routing workflow process over time. Regular meetings must be scheduled during the actual ‘go live’ period to address workflow issues and bugs before staff can create ‘work-arounds.’ Current state and future state workflow mapping, while effective, may never catch ‘what if’ realities that occur on an ad hoc basis
5. Understanding and coordinating the drawbacks of eRx relating to the prescribing of controlled substances and how this variance in workflow integrates into the new electronic environment. (Note: the DEA has published an interim final rule on March 31, with a comment period of 60 days, to permit electronic prescriptions for controlled substances.)

Failure to address any of the points noted above can result in additional cost and frustration, time, and effort.

The 2010 theme, “Let’s Talk! Healthy Conversations for Safer Healthcare,” underscores the importance of communication.Healthy communication between provider, patient, and families helps assure treatment adherence and reduces unnecessary care. Participating hospitals will engage their staff, patients, and community with activities and events that emphasize the critical need for communication for a safe healthcare system.

Lumetra Healthcare Solutions has promoted patient safety at the local level for many years. We worked with managed care and pharmacy plans to develop patient brochures on medication management in several languages. Full communication with their attending physician and pharmacist about all the prescribed and over-the-counter medications being taken is critical, especially for patients who are aging. These brochures discuss the issues of drug-drug interactions and potentially inappropriate medications in laymen’s terms and the importance of keeping an accurate record of all drugs being taken.

We’re happy to make them available again for you to download:

• Managing Your Medicines (English)
• Managing Your Medicines (Spanish)
• Managing Your Medicines (Chinese)
• Managing Your Medicines (Vietnamese)

The success and timeliness of these materials underscore our continuing spotlight on clinical optimization and patient safety. Let us help you find sustainable solutions to your healthcare business challenges. Contact us at newbusiness@lumetrasolutions.com.

Lumetra Healthcare Solutions has extensive experience handling confidential records, which meets government requirements regarding security and privacy. Most government agencies now utilize electronic records, which also play to our organization’s strengths. “Moreover,” Ms. Daniel added, “our experience of 25 years in assisting customers in improving healthcare efficiency and effectiveness enables them to implement lasting changes throughout the continuum of care.”

Combining our expertise in clinical excellence and analytics also provides government clients with important reporting and performance monitoring capabilities.

Value proposition

• Twenty-five years experience with government contracts at all levels
• Panel of 250+ experienced physician reviewers representing all American Board of Medical Specialties
• Familiarity with State and Federal regulatory requirements, including sensitivity to confidentiality and security associated with clinical records and the ability to evaluate potential conflicts of interest

Case example

In 2007, the California Department of Consumer Affairs/Medical Board of California (MBC) contracted with our organization to provide a Comprehensive Study of the Physician and Surgeon Peer Review Process. Our primary goal was to provide the MBC with statistically valid data and rigorous and thorough analysis of the peer review process. We understood the complex nature of this project based on our independent experience working with the peer review community. The study was conducted in 2007 and 2008. A report was issued in 2009 that recommended a separate, independent peer review organization.

Designations

CMAS Approved Contractor

Lumetra Healthcare Solutions is pre-qualified through the California Multiple Award Schedules (CMAS) program to provide evaluation, training, and other pertinent program management activities to state and local governments in California.

GSA Contract Holder

Lumetra Healthcare Solutions has been qualified by the U.S. General Services Administration (GSA) for mission-oriented business-integrated service (MOBIS) projects. We provide in-depth healthcare consulting services for U.S. government agencies and departments who purchase from the GSA Schedule.

Independent Review Organization

Lumetra Healthcare Solutions is fully accredited as an Independent Review Organization (IRO) by URAC. Core standards, the foundation of URAC accreditation, address several key organizational functions including organizational structure, staff qualifications, training and management, oversight of delegated activities, quality management, and consumer protection. The URAC and IRO standards assure that organizations that perform this service are free from conflicts of interest, establish qualifications for physician reviewers, address medical necessity, and ensure reasonable time periods review and appeals processes.

MSA for Business Management Consulting Services

Lumetra Healthcare Solutions is listed on the State of California’s Master Services Agreement (MSA) for Business Management Consulting Services to provide state and local governments in California with organizational development consulting services, including support for the following: team development, conflict management, customer service, process improvement, and training services.

For more information regarding our healthcare solutions for government clients, contact the following:

Patricia Daniel, BSN, CPHQ

Vice President
(415) 677-2108
pdaniel@lumetrasolutions.com

In addition, Lumetra Healthcare Solutions received a subcontract from the University of California at Los Angeles to participate in the Go Grant that was awarded to them by the Agency for Healthcare Research and Quality. LHS will perform the following tasks:

1. Assist UCLA in building the infrastructure for comparative effectiveness research in managed care organizations
2. Create uniform data elements
3. Conduct a pilot study to evaluate quality improvement activities (versus usual care) for cardiovascular and diabetes outcomes

Most recently, Ms. McDougall was a Clinical Review Specialist at a 550-bed facility and a Supervisor at Catholic Healthcare West-Medical Foundation, where she oversaw quality management at one of the largest hospitalist programs in Northern California.

Her experience also includes managed care, preparing for Joint Commission and NCQA audits, HEDIS, and appeals and grievances. Ms. McDougall’s role at Lumetra Healthcare Solutions will be as a Managing Consultant, working with clients on their quality management needs.