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Epiphany Healthcare Blog

How Epiphany Resolved an Enterprise Hospital’s Billing & Order Completion Issue

Posted by Allison Fawber on December 5, 2017 at 2:08 PM

An enterprise hospital using Cardio Server in Alabama contacted us to look for a way to improve their ECG billing workflow.

OPPORTUNITY FOR IMPROVEMENT

For ECG interpretations, there are two bill types: technical and professional. In this particular hospital’s case, the staff would manually change the study status in the EMR to generate the technical component of the bill.  

Of course, if any part of an organization’s workflow is manual, there is always a chance of inconsistency or clerical errors. At times, their manual process led to the hospital not billing the technical fee for performing an ECG. The hospital was losing revenue because, in their EMR, the trigger for dropping the technical charge required that the order status needed to change. In their previous workflow, this was a manual entry, it did not change automatically, and, therefore, the technical bill occasionally was not dropped. The hospital staff realized there was room for improvement and asked Epiphany if there was a way to automate this process. Epiphany’s answer was “absolutely.”

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RESOLUTION

Epiphany now sends an order-status update message from Cardio Server automatically when the study is promoted to Unconfirmed. When Cardio Server sends the automatic update, the EMR changes the order status, which triggers the bill for the technical charge.

Patricia Brewer, an Epiphany Project Manager who worked with the hospital on the implementation, adds, “We are passionate about solving our customer’s problems here at Epiphany and this workflow fix is one of the many things we can do with Cardio Server’s flexibility to better the customer’s use and appreciation of our product.”

The resolution in Cardio Server for this hospital’s problem is not an uncommon request. This type of workflow improvement is what we at Epiphany work to achieve daily. When you calculate the time spent manually entering status change, in addition to lost revenue, automating the process with the help of Cardio Server and your EMR is substantial. If your EMR is able to accept an order-status update message, we can leverage that information to customize your Cardio Server configuration. Sign up for a complimentary workflow analysis to find out how Epiphany can improve clinical workflow for you.

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Tedious Manual ECG Order Reconciliation? Cardio Server has a HUGE Present for You

Posted by Kevin Sekula on November 15, 2017 at 2:09 PM

What is it? Auto-reconciliation. You spend a lot of time manually reconciling studies to orders for tests performed before an order has been placed. We know that. It is a time-consuming, laborious process. We know that too.

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With Epiphany’s Cardio Server, your studies automatically reconcile even if an order is sent after the test has been performed. This is a big deal as other ECG management systems can only offer a manual reconciliation process. A manual process involves many tedious steps to link a study to an order, these are extra steps that waste your valuable time.

Cardio Server can reconcile on patient ID, patient name, and date of study. If these fields do not suit your needs, different fields can be used for reconciliation—the settings are configurable based on your preference.

Emergency Department Benefits

Cardio Server enables a workflow where an emergency department physician makes a full interpretation of the study before an order is placed. When the order comes in and matches to the study, it is automatically confirmed. The reading physician does not have to take another look at the study. This is extremely important as most ECGs in the emergency department are initially completed before an order is placed. This process also helps with the hospital’s door-to-balloon time protocols because the ECGs are confirmed by a physician immediately upon receipt.

No add-on is required for this type of workflow; auto-reconciliation is something our application has been able to do for years. Auto-reconciliation is included with Cardio Server’s default configuration and the settings can be tailored to your needs. Cardio Server’s order reconciliation process greatly reduces manual workflow steps saving clinicians valuable time.

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Cardio Server Replaces Cerner’s Powerchart and Delta Regional is Delighted

Posted by Lisa Wolfenbarger on November 1, 2017 at 10:42 AM

A Letter to Wally Pruitt, Implementations Director at Epiphany Healthcare from Mitch Ainsworth, PACS/Radiology Systems Administrator at Delta Regional Medical Center in Greenville, MS

Wally,

Now that we are a couple of weeks into our go-live, I feel like I can take a moment to catch my breath and put my thoughts on paper about our implementation experience. Epiphany was tasked with implementing Cardio Server in a very short time frame. We communicated our aggressive time-line requirements; the Epiphany team heard our needs and was able to implement Cardio Server to meet them. 

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The team you assembled for this project was the best I have ever worked with. Bob Sturgill was instrumental in keeping the Epiphany team, as well as the DRMC team, on task to meet this deadline. Bob went above and beyond by scheduling time with just he and I to ensure certain milestones were met on time. Bob leaned on his contacts from Mortara to aid in integrating the stress and Holter systems with Cardio Server. Victor Villafaña worked tirelessly with our interface architect to ensure stable HL7 integration with Meditech. Victor also accommodated several changes just prior to go-live and a few optimizations after go-live. The trainer was exceptional as well. Tammy was well prepared to ensure we did not skip a beat while transitioning from Cerner Powerchart ECG to Cardio Server. During a very stressful time for our organization, Tammy kept both the ECG techs and physicians calm and focused while learning the new system.

The professionalism and work ethic of all involved from Epiphany should be commended. I never once felt that we were just another number on a sales sheet.

Your staff made the DRMC team feel as though we were part of a bigger team. The entire team was focused on effectively implementing a system that would aid in how we care for our patients as an organization. The Epiphany staff seemed as vested in this endeavor as we were. I have been involved in several other implementations that did not go so well. Other vendors we have worked with put their best people in sales. After the sale, the customer experience was terrible. From conversations with other colleagues, this seems to be the norm these days. Epiphany deserves to be applauded on this project. From sales to post-live support, it has been a wonderful experience. I feel sure there are a few people that I failed to mention but I appreciate their work on this project too. 

It is not often that the customer is treated as well as we were by Epiphany and you deserve to be praised for it. We are very satisfied with the quality of the system and how smoothly the system was implemented.

Thank you and your entire team at Epiphany for the hard work and dedication during this project.

Kudos to Epiphany!

Mitch Ainsworth.jpg Mitch Ainsworth RT(R)(CT)(ARRT)
PACS/Radiology Systems Administrator
Delta Regional Medical Center
Want to learn more about  our applications?

About Delta Regional:

Founded in 1953 and based in Greenville, Mississippi, Delta Regional Medical Center is a 325-bed facility that is recognized as the leader in the delivery of quality care in the area. Delta Regional Medical Center’s purpose is to provide high quality medical services to the citizens and communities in the Tri-state Delta Region at the lowest practical cost and be a leader in providing needed support services to healthcare providers and patients to improve the health of the communities they serve.

How Epiphany Reduces Repetitive Support Calls with Root Cause Analysis

Posted by Jeff Drabek on October 25, 2017 at 2:57 PM

I became Support Manager at Epiphany in 2016 after working in technical support for Epiphany and learning the application. With 18 years’ experience in IT support, I know that a great product without great technical support loses customers to competition. Both factors, great product and great support, have to be in place for customer retention.

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When I took over as manager, I found that Epiphany’s technical support team, like many other technical support teams, focused on closing metrics. My experience taught me that closing cases as fast as possible does not always satisfy our customers.  Instead, using this method could lead to repetitive support calls on the same problem. I needed to change that metric and mentality to increase customer satisfaction and customer retention.

We changed the focus in our team. We asked them to slow down and focus on individual customer calls to thoroughly understand the root of the problem and not just the symptom of the problem. Focus on solving the root cause of the problem.

When our support technicians slow down, they spend more time discussing and understanding the customer’s environment and workflow requirements. They get to the root of the problem. They also spend more time documenting their findings and solutions. Greater understanding and documentation results in solutions that are leveraged by other team members when a different customer calls with a similar problem. 

A further step in our changed process was the implementation of the ‘round-robin’ support model. Previously, support calls would get assigned to whomever was available. With a close-as-fast-as-possible mentality and metric, technicians were motivated to close support calls without digging down to the root cause. Once solved, they were assigned another support call and another support call and another support call. With round robin, there is an equal distribution of calls amongst the support technicians. Some cases are simple and some complex. The technicians spend more time getting to the root cause on both the simple and complex calls. When they are finished with the simple cases, they have time to thoroughly document their work and time to clear out any backlog.

Epiphany has a great product that makes a difference in people’s lives. Our job as a support team is to provide you, our customer, with great support. Customers under support represent 95.5% of our total installed base.  We are focused on it; will continue to do so.

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Jeff Drabek
Epiphany Healthcare
Technical Support Manager
Office/Primary:(919) 354-5021
jeffdrabek@epiphanyhd.com

As Security is of Utmost Importance to Healthcare IT Professionals, Epiphany Remains Vigilant

Posted by Allison Fawber on September 20, 2017 at 10:44 AM

The U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA) defined national standards to ensure the privacy of patients’ medical records and personal health information.

Healthcare Data Security

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In August 2017, the HIPAA Journal cited measurable breaches in data security for the healthcare industry. Some of the findings revealed:

[B]etween January and June 2017, there have been 233 reported data breaches. Those breaches. . . impacted 3,159,236 patients. The largest reported breach in the first half of the year resulted in the theft of 697,800 records and was caused by a rogue insider, 1 of 96 incidents involving insiders. Out of those 96 incidents, 57 were due to insider error (423,000 records) and 36 incidents due to insider wrongdoing (743,665 records).

This disturbing data implies outside/hacker breaches are less of a threat than non-compliant behavior by your own employees.

Minimizing Risk: Healthcare Security Data Breaches

It is up to your organization’s IT staff to minimize security risks involving equipment that utilizes the latest technology, which includes mobile and off-site access to patient data (such as cardiology and pulmonary diagnostic test results). Epiphany’s engineering team has tested our application and put processes in place to prevent healthcare security data breaches.

What You Can Do

  • Apply data encryption to active and inactive data.
  • Control and monitor all log-ins; train users to log-off when not using applications.
    • Epiphany’s Cardio Server has a customizable, automatic log-off feature to protect PHI.
  • Educate employees and make them active participants in your program to reduce security breaches.
    • Regular training and awareness regarding security are good, constant reminders to keep guards up and maintain skepticism towards phishing scams (emails or phone calls requesting suspicious information).
  • Deploy applications that provide comprehensive HIPAA logs.
  • Put firewalls in place to control employees’ access to at-risk websites.
  • Use secure application program interface (API) technology with authentication and encryption; all points of entry into the system should be tested and documented.
  • Offer secure, remote access to information for physicians.
  • Enable secure, single sign-on using Active Directory.

Epiphany and its products align with best practices for today’s security standards. Read our Information Technology FAQs to learn more about ways we can work together to minimize healthcare security breaches.

Support Contracts: Continuing the Customer Satisfaction Experience

Posted by Monya S. Lindsey on August 16, 2017 at 4:15 PM

Epiphany Healthcare continually strives to meet the needs of our customers. We focus on satisfaction and understanding how to assist you, our customer partner. This focus, alone, drives us to consistently work hard to provide excellent satisfaction each and every time we connect.

One of the ways we strive to meet the needs of our customers is through support maintenance agreements. Why do we focus on support maintenance agreements? We focus on support agreements because of the important value it provides our customers. The support agreement extends the useful life of Cardio Server. The support agreement also provides 24/7/365 support by dedicated specialists and includes upgrades, patches, versions model numbers, product name changes, etc. Software system issues are unexpected and typically occur at the worst possible time. Our support agreements are designed to provide peace of mind and assist with the management of unexpected issues. partnership.jpg

How many times have you overlooked a support contract and it expired? Have you ever experienced an out-of-support situation and support was delayed due to an inactive support agreement? Some of our customer partners have found themselves in one or more of these unexpected scenarios. Epiphany recognizes things happen and have a dedicated team prepared and ready to assist you.

My role as the Support Contract Administrator is to ensure that our customer partners maintain a support agreement. This allows me to continue the customer satisfaction experience by actively engaging our customers with support contract details. This simplified approach involves analyzing customers’ current licenses, generating maintenance agreements, distributing agreements 90 days prior to expiration, and following up 45 days prior to expiration. We engage our customers to ensure each contract is accurate and that support is maintained to avoid support delays.

Our support maintenance process has proven to be an added and satisfying value to our customer partners who applaud us for consistent and proactive follow-up efforts. Let’s face it, we all get busy from day-to-day tasks and may overlook pertinent information. With Epiphany, you don’t have to worry about initiating the annual renewal process for your support contract. We will contact you to start the renewal process and help you maintain support. Please feel free to contact me at (919) 259-0272 to discuss your support maintenance options today.

  

monya.pngMonya S. Lindsey

Epiphany Healthcare
Support Contract Administrator
Office/Primary:(919) 259-0272
MonyaLindsey@EpiphanyHD.com



 

Common Practices and Security Risks

Posted by Russ DeRemer on July 14, 2017 at 10:01 AM

The following is a discussion of three common system configurations and the corresponding security risks.  Epiphany’s best-practice recommendations are included.

Web API 

coding.jpgThe optional Epiphany Web API (application programming interface) supports the ability of another program or application to request information from Cardio Server that is then displayed in a browser window.  

A common use case is to display a link within the patient's EMR record or cardiology PACS application to access diagnostic test results (from ECG, stress, Holter, PFT, etc.).  The user can simply click a link within the EMR or PACS application and the results will appear in a new window.   

When a user clicks on the link, the requesting application (EMR/PACS) creates a request with specific parameters that identify the information needed (i.e., MRN, type of study, date and time of service).  That request, or Web API call, is sent to Cardio Server.  Cardio Server processes the request and provides diagnostic test results in a new browser window.  The request to Cardio Server must follow certain syntax and content as defined by the Cardio Server Web API specifications.

The unencrypted Web API has been made available as an option for use in Cardio Server as a concession to legacy systems and third-party systems that cannot support a properly encrypted API. It is inherently unsecure as it allows any user with access to the system to authenticate with only a known good username.  It is not recommended by Epiphany Healthcare, but will be enabled if requested by the customer.  Exploitation risk: Entity’s staff who have been granted privileges to Cardio Server and have an affirmative duty to safeguard protected health information can access patient records inappropriately.

HL7 PDF link

Many Epiphany customers use Cardio Server as the official image archive for cardiology and pulmonary diagnostic test results.  In order to support customer requests for easy retrieval, some customers prefer to include a static URL link to Cardio Server in HL7 Results messages.  The link displays a specific diagnostic test result.   

The use of a PDF link in HL7 Result messages has been made available as an option for use in Cardio Server as a concession to legacy systems and third-party systems that cannot support a properly encrypted Web API.  It is inherently unsecure as it allows any user with access to the system to possibly access PDF files, given certain information.  It is not recommended by Epiphany Healthcare but will be enabled if requested by the customer.  Exploitation risk: Entity’s staff who have been granted privileges to Cardio Server and have an affirmative duty to safeguard protected health information can access patient records inappropriately.

Server Access Outside of Secure Network

Cardio Server can be configured to permit internet-facing login and access.   

Making the server available outside the hospital network, without additional security access controls (e.g., VPN or portal), is STRONGLY DISCOURAGED as the entity’s security exposure/risk is greatly enhanced.  Exploitation risk: Substantial risk of third–party, malicious penetration.   

In addition, the use of Active Directory password integration is recommended for Cardio Server installations.

Contact an Epiphany representative if you have any questions or would like to discuss this matter.

Consider the Profound Impact of Bidirectional Communication on Healthcare

Posted by Allison Fawber on June 27, 2017 at 1:30 PM

If speed and efficiency are the name of the game, what is the winning combination? Bidirectional communication.

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Bidirectional communication is the ability to send information in both directions, from the EMR to the acquisition device and back. Within the healthcare industry, this exchange between electronic systems and technology devices positively impacts the quality of care.

Information and Communication Technology: How it Works

Information and Communication Technology (ICT) in healthcare raises the quality of patient care because its platform is more patient-centered. ICT also puts information in the hands of the medical professionals when they need it most—immediately.

  • Patient records – Paper-based systems become bulky and disorganized with storage spaces that are overfilled and difficult to navigate. Computerized record-keeping starts at the admissions desk and continues through discharge. It keeps subsequent admissions and patient care data in an electronic file.
  • Modality worklists – Patient data can be transferred between the hospital’s EMR and the electronic device.

ICT Reduces Errors and Saves Time

When patient information is available anytime/anywhere, there is no need for manual data entry, thus reducing human errors.

  • Orders can be directed to a specific cart or location and then downloaded by a user.
  • Communication can be protected by Secure Sockets Layer (SSL).
  • Duplicate data – Different medical professionals entering the same data, over and over, increases the risk to patient confidentiality and wastes valuable time.

Bidirectional Communication for Greater Efficiency

Patients’ healthcare is compromised when their medical-information management is less than optimal. If your hospital has been postponing the addition of ICT, you’re losing time when you could be implementing changes that will save time.

Progress means interoperability and interoperability means efficiency. Epiphany has implemented communications technology that reduces time and duplicated efforts with its Cardio Server platform; a major advantage for physicians as they can access data 24/7 from remote locations to better manage patient care. And as a benefit for technicians, modality worklists prevent human error from manual data entry. Worklists allow for bi-directional communication with cardiographs, stress, Holter, PFT devices, and more.

Contact us to learn more about enhanced healthcare through increased efficiency.

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How IT Advancements Such as ECG Management Enhance Healthcare Communication

Posted by Allison Fawber on June 21, 2017 at 7:07 AM

 

All industry sectors work hard to keep up with a constant onslaught of technological advancements. In healthcare, technology innovation has led to some miraculous discoveries; indeed, the industry barely resembles what was perceived as cutting-edge care only a few decades ago.

Of course, the advancements that generate the most buzz are directly related to patient diagnostics and treatment. New drugs, imaging technologies, or surgical devices often make international news. But on the inside, for the medical personnel that move mountains to provide best-in-class patient care every day, innovation in healthcare communication is perhaps even more revolutionary.

Software Has Changed the Way We Communicate

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In the modern hospital, communication platforms are the most-accessed, most universally necessary, and arguably most important infrastructural elements. No number of high-tech surgical devices or fantastically skilled staff members can solve modern medical problems if they can’t talk to each other. That communication needs to be fast, reliable, secure, and comprehensive.

Cardio Server, Epiphany’s web-based ECG management software, is hardware independent, which means that your network, your servers, and your domains remain untouched. The application gives healthcare providers access to instant communication regardless of time, distance, or device. And, since we are compatible with over one hundred devices from a variety of vendors, Cardio Server helps your organization become more interoperable.

 “Effectiveness” is Measurable

Using metrics to help determine what makes communication “effective” takes the guesswork out of software upgrades and allows hospitals to quickly see the value in healthcare-technology advancements. How long does it take to access ECG data and how many individuals access that day each day, each month, and each year? How is that data entered and how long does it take to enter? Is data entered once or multiple times? To determine whether your ECG communication is effective, first answer these questions; then consider whether there is room for improvement. What about cost savings based on wasted resources? How often is data keyed inaccurately? How often is data lost entirely? Epiphany has tools in place to offer you a free workflow analysis, which allows you to analyze your processes to see where improvements might be necessary.

Additionally, Cardio Server’s platform contains an extensive reporting package that allows you to analyze your data. The report functionality can help with administrative needs, billing needs, or help determine workflow efficiency.

Cost is Practical

When a healthcare organization can leverage its current devices and infrastructure and use one software program to manage all of their different diagnostic modality tests, the result is outstanding financial return on investment.

ECG management has been available in the industry for over thirty­‐five years. Until now, it has been both expensive and limited to certain acquisition devices. Implementing ECG management generates significant clinical benefits for patients and dramatic cost savings for your facility. 

Patients receive better care when ECG management is coordinated between departments in the hospital. ECG management streamlines procedures in the Operating Room and Cardiology Department, but its life-saving benefits are most profound in the Emergency Department.

Financial benefits include saving at least $7.00 per exam for resting ECG tests. ECG management eliminates the costs of all those “chart pulls” that consume staff time and facility materials.

It is Time to Modernize

ECG management software has changed the way we communicate, helps analyze processes, and results in outstanding financial ROI. Break down the barriers to productivity in your organization and learn more about Epiphany’s Cardio Server ECG Management system today.

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Why Epiphany Hospital Customers Should Consider Adding Clinics and Physician Practices

Posted by Allison Fawber on June 1, 2017 at 10:37 AM

Does your organization have multiple, hospital-owned physician groups, internal medicine, or cardiology clinics where you share services? Are these clinics faxing studies to cardiologists at the hospital for over-reads and then requiring those studies to be faxed back? This communication process is not only time-consuming but also adds additional labor costs. As an example, studies are printed and then scanned into the EMR. The many manual steps involved in data handling, such as printing, scanning, or faxing, are an inefficient use of clinical and administrative staff.

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Many of our customers are moving to a model where the hospital leverages its Cardio Server system by adding their clinics and physician practices, so they can utilize the system as well. While we also support clinic add-ons for smaller hospitals just adding a couple of facilities, some of our hospital customers are adding over 50 clinics and physician practices.  

Multiple sites sharing healthcare IT systems usually have diverse legacy devices and cannot afford the typical proprietary solutions that require them to replace working devices from various manufacturers. Since Epiphany is compatible with 125 devices from over 45 vendors in 15 diagnostic modalities, we can support different legacy devices at each site.

Our customers have also shared with us that in multi-site configurations, each hospital system needs to be able to define its own flexible workflow. Epiphany supports the ability to adjust Cardio Server to fit different workflow preferences. We have numerous configuration options that can provide workflow for different facilities within the enterprise. Most often, large enterprises are looking for consistency. Our experienced project team analyzes and evaluates existing workflow and develops a uniquely tailored, best-practices workflow that can be applied across the enterprise to provide a consistent, high-quality clinical experience for physicians and patients.   

Benefits of Adding Clinics & Physician Practices:Sites_dropdown.png

  • Eliminates printing, faxing, and scanning reports.
  • Main hospital site and all additional sites can be easily accessible based on permission settings. (See image.) 
  • When available, previous ECGs are provided for side-by-side comparison, calipers, and other advanced functionality.
  • Patient diagnostic study results are available in both the main hospital EMR and the clinic EMR.
  • Notifications to referring physicians at the clinic/physician practice that a study has been over-read so they can properly diagnose and treat the patient.
  • Allows access to Cardio Server from virtually anywhere. 

Now is the perfect time to leverage your Cardio Server system and experience the benefits of adding your organization’s clinics and physician practices. 

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