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Open App Spotlight: Relying on EHRs to better prep for surgery

A healthy 40-year-old recently had a knee arthroscopy.  Throughout the process, clinicians asked him the same questions time and again.  His clinicians didn’t seem to have access to his important medical information.

Before the arthroscopy, caregivers ordered an ECG and blood work, which required the patient to take an additional day off work.  When he asked if the tests were necessary for someone so healthy, they responded, “this is what we always do for these procedures.” No matter if he really needed the tests.

It shouldn’t be this way. Patients and caregivers should have information at the point of care to conduct the right tests – and only the right tests – before surgery. One of our Open App Challenge Phase 1 recipients, ePREOP, addresses this goal and promotes best practices in surgical care.

Keeping surgeries on schedule with the right tests

Dr. David Bergman, the founder and CEO of ePREOP (and a practicing anesthesiologist) is troubled by how often patients are improperly evaluated before surgery. Without the correct tests and authorizations, surgeons or anesthesiologists delay and cancel procedures – sometimes at the last minute. It’s inconvenient and frustrating for patients, their loved ones and caregivers.

On the other hand, “many patients scheduled for surgery present with unnecessary tests and consults,” said Dr. Bergman. “It’s putting additional burdens on these patients and the healthcare system.”

Experts estimate preoperative testing costs about $18 billion per year, and studies show up to 60% of these tests are not necessary. Remember, these are tests that can cause patients inconvenience, anxiety and discomfort. Sometimes false positive results will initiate further and more invasive testing.  And unnecessary tests consume time, space and resources that could be used for those patients who really do need the tests.

“Hospitals are losing money as tests and consults get bundled into the surgical encounter fee,” according to Dr. Bergman. “Patients frequently receive bills for tests that should never have been done in the first place.”

Integrating with Electronic Health Records (EHRs) for best pre- and post-operative results

ePREOP integrates surgical  procedure preparation with the EHR (you can watch an ePREOP demo video). Directly out of the Allscripts application, ePREOP launches scheduling, authorization, clinical decision support and discrete data transfer tools. Surgical case information moves efficiently from doctor’s office to hospital and back to the doctor’s office.

Patients have more accurate and standardized pre- and post-surgical instructions, which reduce the risk for complications.  Surgeons can decrease their administrative burden while reducing case delays and cancellations.  Nurses save time on documentation. Hospitals save money on Diagnosis-Related Group (DRG) reimbursement.

Bottom line, ePREOP supports better patient outcomes at a lower cost.  It provides essential clinical decision support directly at the point of care.

“We engage providers and hospitals by linking the CDS [Clinical Decision Support] reports with administrative processes. This capability helps coordinate workflows across different platforms,” said Dr. Bergman. “ePREOP is thrilled Allscripts shares this vision and has given us the opportunity to deliver our system on its physician and hospital platforms.”

Being Open enables apps to meet specific needs of patients and caregivers

Apps like ePREOP help bring the full benefits of the EHR to the surgical process. Surgery is complex enough without having to rely on repeated interviews or ‘shotgun’ testing.

Allscripts has a responsibility to deliver an EHR that meets all the latest guidelines, and we do heavy lifting to keep up with all of them, including Meaningful Use. Beyond those requirements, our clients and their patients have a range of specific needs.

And that’s the beauty of an Open platform. For surgical practices that need an app such as ePREOP, Open enables us to bring this innovation into the fold.

Editor’s Note: Open App Spotlight will feature other Allscripts Open App Challenge Phase 1 recipients over the next several weeks. The challenge reflects Allscripts commitment to being Open to innovation, and why Open matters to the future of health care. To learn more read the Open App Challenge news release, or to see stories like these in person, join us in Chicago this August at Allscripts Client Experience (ACE13).

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