My Blog
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- Added new Mapping file for Ftp interfaces.
- Contacted a number of Practices for kick-off phase of their results distribution project.
- Working with a Greenway to finalize the hospital costs for interfaces. Requested resubmission removing unwarranted costs and submission of a better per interface price. Received and is currently being processed.
- Working with eCW for printing of interfaces. Requested we work on interface build and connectivity while the interface quote is being processed.
- Create office definition for all the practices targeted as PRIMARY by client.
- Medquest: Took interface Live on Tuesday – messages are passing
- Automate Trouble shooting: researched files sent to QMS/Med Assets/Imacs (Claims Files)
- Automate Trouble shooting: Created new task to transfer inbound PMS files
- NPR Request: Medai file re-submissions.
- NPR Request: Worked with Meditech on Scheduling NPRs
- NMI – Bar Psych Notes processing
- EGate On-call: Monitored, handled various EGate alerts
- EGate, Cleaned up PWH EGate Monitor
- Completed adding timer triggers ADT interfaces
- Testing Meditech ADT batch interfaces
- Debugged and updated flat file message definitions for Lawson DFT refund file
- Provided sample queries to insert, update and modify FTP logging DB
- Added new ADT route connections and facility conditional filtering
- Added new javascript connectors for Lawson DFT batch route
- Updated system documentation
- Performing analysis on Velos message extracts
- Created Velos FlatFile specification
- Created Velos Interface specifications
- Created a Velos Interface in Rhapsody used for demonstration
- Debugging/testing on Muse URL image link
- Resolved Xcelera image links
- Resolved Epic Bridges errors.
- Specifying requirements for a new custom Web based transcription interface
- Created extract of 50K summary note records from Practice Partner, taking measurement of the time it takes in order to gauge duration of actual file extraction containing 1.6 million records.
- Got initial LAB (micro and discrete) records to file into Epic.
- Got initial RAD records to file into Epic.
- Got initial Immunization data to file into Epic.
- Working on getting historic vitals data to file into Epic.
- Troubleshoot conversion issues, documenting issues and providing feedback to involved parties.
- Eclipsys/Allscripts RIS integration meetings, correspondence, and documentation review.
- ePI post-activation issues review meeting.
- Correspondence, assemble Objects Plus training material.
- Received Meditech and Epic specifications
- Reviewed Specifications
- Completed VPN and Epic access forms
- Met for QuickBase demonstration
- Updated QuickBase Project plan
- Complete GAP analysis of mapping process.
- Speak with appropriate team members about progress of Code Mapping
- Added new Mapping file for Ftp interfaces.
- Completing timer trigger testing for batching Ftp billing interfaces
- Testing Meditech ADT batch interfaces
- Debugged and updated new mapping for Lawson DFT refund file
- Added new conditional connectors for Meditech DFT batch route
- Updated system documentation
- Provided additional mapping on Muse, Apollo, and Xcelera ancillaries
- Performed functional testing Muse, Apollo, and Xcelera ancillaries
- Performed Cross browser testing on Xcelera URL image links
- Assisted with additional Epic DFT billing to GE IDX testing.
- Corrected Epic Bridges errors.
- Researched why EGATE log files were not being archived
- Reset Egate user passwords
- Researched ER transactions not being sent to OSF
- Modified translations to address issue
- Researched ability to resend transactions
- Collected data to be resent from inbound ADT log files
- Transferred files between servers
- Extracted only HL7 records
- Filtered out non E/R patients
- Filtered out non-ADT messages
- For the Star to Medstreaming ADT/Orders Interface:
- Modified Orders interface to copy ORC:3 to ORC:2
- Modified Orders Interface to copy OBR:3 to OBR:3
- Initial draft completed for Admission MD Test Script,
- Draft started for Admission NP; Draft of new ClinDoc RN Testing script passed to for review.
- Epic Anesthesia project status meeting conducted.
- Anesthesia build continues on schedule.
- Team meeting with Epic to update current status and incorporate our tasks to parallel output tasks.
- Content development meetings with Cardiac Anesthesia.
- Project status session and update project documentation.
- Touchscreen monitor demo complete – Elo Touchscreen 19” selected.
- Meeting held with ASAP regarding assistance with build of Sedation workflow for ED physicians.
- This week for ASAP, staff presented a reporting workbench demonstration and are currently working on creating reports and templates for Southern facility based on existing Northern facility reports and templates. ASAP also working on duping navigators, topics and sections and adding smart text.
- Team met to discuss build assignments and impact of Sedation workflow to HOD. Attended Sedation workflow sessions. Continued to work on build assignments and everything on track for team to this point.
- This week the EPIC Radiant team completed the SER import spreadsheet and have submitted modality/room build details to the client for final review before import by Cadence team. Build efforts continued for user-related build (e.g. generic users for build/test, front desk activity, tech work lists, etc). Minor progress was made toward development of test scripts.
- Visit Conversion - Got a number of visits to load after making tweaks to conversion extract messages. Provided list of needed changes to extract programmer, in order to go through next round of initial testing.
- Summary Note Conversion - Made final requested changes to content of note. Made Perl script changes to embed note into HL7. Got first conversion summary note load into Epic. There are still problems with mixed RTF/text content display in Epic, but we will work out next week.
- Apollo Note Conversion from Oacis - Began initial testing of Apollo note backload into Epic.
- Rad Result Conversion from Oacis - Began initial testing of RAD result conversion into Epic. Testing cannot continue until procedure and result item build occurs into testing environment.
- MPI Duplicates - Created additional list of Practice Partner duplicates, comparing to Epic’s list, and flagging ones not found there. Provided list to Medical Records to work through.
- Post ePI activation correspondence and issues calls
- RIS related correspondence
- Epiphany related correspondence and discussions
- Added route to handle mapping HL72.3.1 to 2.5.1 in Rhapsody.
- Created an archive database and communication point in Rhapsody that will archive all incoming messages.
- Unit testing incoming test Lab messages
- Testing timer trigger for batching Ftp interfaces
- Performed Rhapsody 4.1.1 IDE upgrade.
- Debugged and added new functionality for Ftp File logging.
- Updated system documentation
- Completed message analysis on Apollo results messages
- Providing mapping changes for Cloverleaf from Apollo
- Performed additional Epic DFT billing message testing.
- Corrected Epic Bridges errors.
- Participated in meetings: All Hands, Ensemble Team, Data Courier Demo
- Rescheduled call with GE to discuss the Medication History Project and their interface requirements.
- Conducted farther review of the interfaces involved in the Medilinks system.
- Continued creation of the business requirements documents for assigned interfaces.
- Built out the codesets for Medicity preparatory staging of ProAccess.
- Tested dataflow to Medicity Dropbox for multifacility client. Worked with GRID analyst to fine tune dropbox display.
- Monitoring Medicity Nexus Manager and NovoGRID non-processed messages to assist facilities in troubleshooting data integrity issues before go-live.
- Cardiology Reports Interface – Attended the kick off meeting to discuss first steps for this new reports interface.
- HIE Patient Consent Internal Meeting – Attended this meeting to with the Hospital team to define their strategy for meeting requirements associated with patient consent and sending highly confidential data to the HIE.
- HIE Patient Consent Meeting – Attended this meeting to discuss with other HIE early adopter Meditech organizations the plan for addressing legal and resulting technical requirements associated with patient consent and sending highly confidential data to HIE.
- HIE ADT Gap Analysis – Received a list of 10 questions from HIE that required extensive research, detailed responses and detailed updates to the Action Item List Document that I’ve been maintaining on this side to track work items identified and their status. Reviewed one final time the list of fields identified as requiring HL7 translations or Meditech mnemonic/description lookups with a focus on solution strategies and Meditech dictionary extract and consolidation tasks that will complete for the ADT items which are the most numerous. Took first stab at mapping (documented Excel spreadsheets) the facility Meditech to HL7 Table Value translations for Race, Marital Status, Ethnicity, Employment Status and Admission Priority and shared those mappings with Rich for review/approval.
- HIE ADT e*Gate Development and Testing – Completed e*Gate development and testing for several (based on availability of Meditech dictionary extracts for certain fields) HL7/Meditech code translations as well as for several miscellaneous changes per new issues reported by the HIE team.
- HIE LAB Gap Analysis – Completed mapping of LAB/MIC Department Prefix values to HIE Lab Test Categories and documented the mapping in an Excel spreadsheet. Subsequently, provided the documents for review and approval which I received the same afternoon. Completed detailed research on the structure and format of OBR.15 (Specimen Source) for the Meditech LAB Results feed identifying that it will not be possible to map these codes to HL7 Table values based on the complex nature of the task and their resources’ inability to engage the task due to their heavy workload. Communicate this to the team and let thim know that we would implement solution to provide description (in addition to mnemonic) for the 2 relevant Meditech dictionaries (Source Category and Specimen Description).
- HIE LAB e*Gate Development and Testing – Completed e*Gate development and testing for several items from the action item list with particular focus the transformation rules necessary to extract the LAB/MIC Department Prefix from the Specimen Number (OBR.19) followed by translation of that value to the HIE Lab Test Category values.
- HIE HC PHI Filtering (5 hours) – Pulled together notes and team feedback in order to create the first draft of the design/strategy for implementing HC PHI filters within e*Gate using dictionary item HC PHI lists for location, lab tests, diagnoses, etc. Provided this document to the rest of the team for review. The document will be used as a requirements document for the e*Gate implementation of the HC PHI filter rules.
- Reports Interface – Completed testing of the new port connection to Heartland for the new reports interface. The connection was not successful and subsequent research showed that the VPN tunnel required an update on the Medinformatix side. Requested that change and successfully connected once the change was complete. Also, tested first report message and currently looking for regarding the test. To create the report message, had to pull a report from production and manually edit the HL7 message to use the “TEST” patient for Heartland because Heartland does not have a separate “TEST” system.
- Go live occurred on November 5th and since then we have been working to trouble shoot an array of items uncovered at go live. Some process flows needed to be modified once implemented.
- There were and continue to be issues surrounding server uptime involving the integration engines that are being addressed by the IT infrastructure group.
- We have provided assistance to cover go live support for interfaces to covering 24 hours a day.
- Despite the issues uncovered, the entire system was brought on line and has had over 95% uptime in the previous 2 weeks.
- Preparations are now being made for phase 2 of the implementation, the second facility to be brought live.
- Testing timer trigger for batching Ftp interfaces between EPIC and Rhapsody.
- Testing ADT for GetWell Network and AtStaff from Meditech
- Performed local Rhapsody 4.1.1 IDE upgrade.
- Performed Rhapsody 4.1.1 IDE upgrade on Hospital laptop.
- Debugged Ftp File logging route.
- Completed message analysis on GE Muse messages
- Completed message analysis on Xcelera messages
- Performing message analysis on Apollo messages
- Providing mapping changes for GE MUSE and Xcelera
- Performed additional Epic DFT billing message testing.
- Corrected Epic Bridges errors.
- Commenced GE Muse functional testing
- Debugged GE Muse ECG hyperlink and login details
- Assisted in adding new Epic Resulting agencies Apollo, GE Muse, Phillips Xcelera
- Resolved remote VPN connectivity.
- Correspondence and calls regarding Epiphany cardiology project.
- Helped configure Media Viewer icon in SCM and tested URL results into SCM.
- ePI post activation correspondence and calls.
- Provided examples of summary report display to decision makers, incorporating requested changes to my extract program.
- Reviewed Epics list of patient dups during mpi backload. Plan on comparing to my list of dups from Practice Partner, to see if there are any outliers.
- Modified Immunization and Vitals extraction scripts per team suggestions.
- Met with Epic while onsite to review/resolve conversion related issues.
- Received access to Epic at the end of the week. Began unit testing visits conversion, tweaking messages along the way.
- HIE LAB Gap Analysis Internal Meeting – Attended and participated in this meeting to discuss solution to map Meditech LAB/MIC Department Prefix to HIE Lab Test Category.
- LAB Results POC Interface – Coordinated and participated in this meeting to discuss the POC interface to Meditech via e*Gate. Remote install scheduled for next week.
- HIE Patient Consent Internal Meeting – Attended this meeting to discuss with the hospital team to define the hospital strategy for meeting requirements associated with patient consent and sending highly confidential data to HIE.
- HIE Patient Consent Meeting – Attended this meeting to discuss with other HIE early adopter Meditech organizations the plan for addressing legal and resulting technical requirements associated with patient consent and sending highly confidential data to HIE.
- HIE ADT Gap Analysis – Closed out issues with DG1.6 (Diagnosis Type) and PR1.6 (Procedure Type) fields within BAR^P01 messages based on research provided to and response received from Brian Nerzig of MCHIE. Provena will not attempt to default values into these fields when Meditech doesn’t provide one because Brian Nerzig stated that the impact was negligible on the MCHIE side if the fields are left null/empty.
- MCHIE LAB e*Gate Development and Testing (10 hours) – Completed e*Gate development to implement filtering and transformation rules based on the action items list yielded from the LAB Gap Analysis phase. This included creation of placeholder rules for each field that will require either HL7 Code translation or Meditech Mnemonic to Name translation, etc. Completed detailed testing using high volume of production LAB result messages.
- MCHIE ITS (Rad and Departmental) e*Gate Development and Testing (10 hours) – Completed e*Gate development to implement filtering and transformation rules based on the action items list yielded from the ITS Gap Analysis phase. This included creation of placeholder rules for each field that will require either HL7 Code translation or Meditech Mnemonic to Name translation, etc. Completed detailed testing using high volume of production ITS report messages.
- HIE “coded field” (HL7) Translation Requirements Analysis and Documentation – Worked field by field through the HIE Coded Field Translation document (ADT, LAB and ITS) to develop a strategy for mapping from Meditech Mnemonic to HL7 Table Value or replacing a Meditech Mnemonic with a Meditech Name (dictionary lookup) depending on the HIE requirements and direction provided by the HIE team. Subsequently, expanded the document to include columns for tracking the solution strategy (e*Gate inline code translation or “datamap” file based translation) and the strategy for maintaining the resulting mappings (via Meditech dictionary add/change/delete/inactivate notifications from clinical team to integration team within IS department). Generally, updated the document as the week progressed and will use this document to drive the work that will be completed next week to implement each data map file based translation.
- Provided detailed research and resolution ideas for the space problems currently occurring with a couple of the logical drives in the production environment. Resolved an issue with the “VendorFTP” control broker that caused the Datanex “DRA” interface to fail Monday morning 11/7 as reported by Sentry Systems technical support. Cleared a ton of space on the offending drive by deleting all but 30 days of archived data files for the various batch interfaces running in the “VendorFTP” schema along with a control broker shutdown/restart.
- Worked on client’s MEDITECH 5.64 Upgrade.
- Continued correspondence and meetings following ePI activation.
- Meetings regarding Epiphany project. Helped confirm that Epiphany reports could be displayed from Allscripts’ TSC hosted equipment. Review materials pertaining to the setup of camera icon in SCM.
- Meetings regarding ePI/EAD solution to handle registrations from Allscripts Ambulatory.
- Nearly complete with Perl script to extract Labcorp discrete data from McKesson Practice Partner to import into Epic. A few questions remain that need to be answered before continuing:
- Need to get mapping of catalog item codes from Practice Partner to Epic.
- Need to get mapping of ordering provider IDs from Practice Partner to Epic.
- Epic is concerned with grouping of discrete results by date time. Suggested sending one discrete result per message. Need to finalize.
- Completed Perl script to extract note type LabCorp data from PracticePartner.
- Wrote Perl script to create Vitals Signs extract from Practice Partner.
- Wrote Perl script to extract Immunization data from Practice Partner.
- Participated in specification review calls for Labcorp notes and summary notes.
- Started writing Perl script to extract summary report data from Practice Partner. Reviewed initial output with management at client site.
- Participated in call to review conversion related questions. Further related meetings scheduled next week while Epic is on site.
- Wrote program to summarize procedure codes sent in visit backload. Discovered that are a few codes that are shared among many procedures. Need to resolve.
- Working on getting access to Epic. Can begin unit test of visit and results backload when access is ready.
- Performed ADT message testing on five ancillary systems
- Added new functionality to five ancillary systems for batching and ftp
- Updated Ftp data extracts for transfer logs
- Built new mappings to translate GetWell Network and AtStaff from Meditech format to the ancillary systems data format
- Debugged 5010 278 messages for United HealthCare format
- Updated system documentation
- Commenced results analysis on GE Muse and Xcelera messages
- Reviewed Neurophysiology Xcelera system business requirements.
- Reviewed GE Muse system business requirements.
- Performing Muse Results message analysis.
- Assisted in communication testing with charge interface
- Assisted with charge message changes between Epic and GEIDX
- Troubleshooting VPN remote connectivity
- Set up meetings with organizations and vendors regarding middleware selection for Anesthesia.
- Build for anesthesia module
- Content development with Physicians and Cardiac Anesthesia
- Review broken pointers in BLD with Epic
- Bi-weekly meetings Anesthesia and Orders.
- Monthly meeting with Anesthesia Team to discuss project status.
- Discuss future-state sedation workflow with ED sedation physician champion.
- For build, ASAP duplicated navigators, entered department settings, created track board views, duplicated profiles and created a security class.
- Team met to discuss build assignments. Assignments were agreed upon and the team began building tasks. Also reviewed all test scripts from Northern Facility and adjusted scripts to meet any changes in the Southern build.
- Completed final draft copies of workflows with final edits completed on Monday, Printed copies will delivered next week.
- Scope presentation complete.
- Build document was reviewed and proposed assignments were made, waiting for review and comments
- Draft project plan was submitted, waiting for final dates and completion of draft, meeting will be scheduled to review line by line.
- Meeting was completed with materials management, interface development will be needed to support the SUP location.
- Touch base meeting occurred with OpTime and Learning services.
- Radiant DEP build 95% complete in BLD:
- Continued to engage application teams (e.g. Cadence, Resolute, etc) to coordinate non Radiant-specific build items
- Radiant SER build 90% complete:
- Completed documentation of item-level build for new modality SER records
- Documented build ready for handoff to Cadence team
- Attended meeting with Microsoft to generally discuss the HIE requirements for sending HL7 Table Values for “coded” fields.
- Attended and participated in this meeting to discuss LAB Gap Analysis findings and action items.
- Received notice that the VPN tunnel re-build was complete and was shocked to find that the connections started functioning properly again for all 4 data feeds to HIE. Subsequently, worked at length to re-queue (via new e*Gate feeder components) the backlog of 400,000+ messages that built up while the connectivity issues were experienced. Notified the HIE team and the facility integration team that the issues were resolved and the backlog was completely processed.
- HIE ADT Gap Analysis – Received research and feedback on the ADT Response / Action Items document and incorporated his feedback into the “gold” copy. Subsequently, completed some research and production data mining for the one open issue involving PR1 segments from the ABS messages and shared that research via detailed email and attachment of the PR1 data in spreadsheet format. Also, reviewed and responded to all questions posed in the “Microsoft Comments” column he added to the spreadsheet per the Meditech Dictionary / HL7 Table Value tracking spreadsheet. In each case, cited these questions alongside the facility response.
- HIE LAB Gap Analysis – Researched, developed and documented proposed solution for mapping LAB/MIC department prefix values (extracted from Specimen Number in OBR.19) to the HIE Lab Test Category values and emailed the proposal for review and approval. Subsequently, scheduled meeting for Monday morning 11/7. Updated LAB Gap Analysis action items list based on the LAB Gap Analysis meeting with HIE. Also, updated facility/HIE dictionary translation document based on that meeting and follow up internal meetings.
- HIE ITS Gap Analysis – Received HIE categories for both Radiology and Transcription of HIE and updated the facility/HIE dictionary translation document to include both lists of category values and associated HIE descriptions. Completed review of the HIE categories against the fields (and dictionary values) supported in the ITS messages (procedure and report) and concluded that we will have to translate Meditech Procedure Categories to HIE Radiology Categories for Radiology Reports and Meditech Report Type to MCHIE Transcription Category for Departmental Reports.
- HIE ADT e*Gate Development and Testing – Completed e*Gate development to implement filtering and transformation rules based on the action items list yielded from the ADT Gap Analysis phase. This included creation of placeholder rules for each field that will require either HL7 Code translation or Meditech Mnemonic to Name translation, filtering out “empty” PD1, GT1, UB2 and MRG segments, normalizing “unknown” SSN values, filtering out BAR^P01 messages that do not contain diagnosis or procedure data, etc. Completed detailed testing using high volume of production ADT/BAR messages.
- ITS to Meditech e*Gate Development and Testing – Completed e*Gate development and testing support of collaboration rules script for this interface that transforms and sends progress reports to Meditech via the inbound HL7 ITS interface. Mapped Referring Provider (PV1.7) to both the Ordering Provider (OBR.16) and Dictated By (OBR.32) fields on the Meditech ITS side. Completed detailed testing of five reports all the way into Meditech and verified that the report filed properly. Subsequently, requested the creation of a new generic transcriptionist within Meditech and updated the interface code to default OBR.25 to the generic transcriptionist for these reports into Meditech.
- e*Gate Update 2 Schema Migration Documentation – Pulled the schema migration documentation out of the e*Gate U2 Installation document and moved it into a separate “Schema Migration” document. Completed some research based on previous Epic schema migrations to Update 2 and enhanced the document to include up front steps required to updated the various e*Gate configuration artifacts (HL7 e*Ways, JMS e*Way Connections, IQ Manager DB Settings, etc.) and provided the updated document to the team for future planning of schema migrations to Update 2.
- Continued correspondence and meetings following ePI activation.
- Meetings and development of Objects Plus tab to allow Epiphany WebAPI to show up in SCM.
- Nearly complete with Perl script to extract Labcorp discrete data from McKesson Practice Partner to import into Epic. A few questions remain that need to be answered before continuing.
- Need to get mapping of catalog item codes from Practice Partner to Epic.
- Need to get mapping of ordering provider IDs from Practice Partner to Epic.
- Epic is concerned with grouping of discrete results by date time. Suggested sending one discrete result per message. Need to finalize.
- Took sample timings of program Labcorp extract program above and found that 11,955 result lines took 2 minutes and 20 seconds. Scaled to the full Labcorp discrete result conversion, it should take around 5 hours, generating a 180 MB file.
- Wrote Perl script to call DLL converting HTML files to RTF, which is a supported document format for Epic. By utilizing this DLL, bypassed need to purchase programs to handle translation. Observed throughput translating 200 files was 2 seconds.
- Wrote script to look for duplicate patients in the Practice Partner database, ranking output by how many matched demographics exist. Provided report to management.
- Began work writing script to extract note type Labcorp data from Practice Partner. This program will be able to modify slightly to handle every other note type conversion from Practice Partner.
- Performed ADT message testing on GE-Sax, Emageon and X ancillary systems
- Completed DFT billing message analysis on GE/IDX messages and Epic messages
- Delivered mapping requirements for Epic outbound billing interface.
- Generated mocked up DFT message for testing.
- Reviewed and verified charge triggers through Epic application TST and POC environments.
- Reviewed Neurophysiology XLTek system business requirements.
- Reviewed GE Muse system business requirements.
- Performing Muse Results message analysis.
- Assisted in communication testing with charge interface
- Commenced requirements gathering for Velos notes interface
- Developed a duplicate MRN route to check for Oacis duplicate patients.
- Continued provisioning of Practice Nodes on the Hospital Node; continued deployment, training, & support of iNexx Inbox for independent ambulatory practices.
- ProAccess: Identifying practice for validation of Hospital Interface in ProAccess 5.3 CERT.
- Inbox: Installed iNexx Platform for a number of practices; scheduled meeting with facility SMEs on solution for issue of routing results by facility.
- ProAccess 5.3 Upgrade: Executing Phase – continued validation of 5.3; planning for PROD build & deployment; continued monitoring of project status and tracking of deliverables.
- Advance Directives Interface: Controlling Phase – completed testing with vendors; tracking & escalation of testing issues; scheduled demo for physician & executive sponsors; monitoring project status.
- Greenway Gateway: Executing Phase – conducted Kick Off Call with vendors & facility; gathered & compiled all technical & site-specific interface information for vendors; continued completion of Practice Planners for eHP practices for Phase 1 HL7 interfaces.
- Sansum-PDL Orders Interface: Executing Phase – provisioning of users in PDL Work List; final go-live preparations with PDL for next week; continued monitoring of project status and tracking of deliverables.
- SB Cardio-PDL Interface: Controlling Phase – coordination of results validation between facility & PDL and Prime Clinical EHR; continued monitoring of project status and preparations for go-live.
- Medicity Training: Continued training of Hospital & PDL staff on DropBox, EHR Interfaces, and ProAccess. Continued training of independent ambulatory practices on Dropbox.
- Documentation: Grid-EHR Interface Process; Interface Configuration Matrix; Medicity Practice Planners; status reporting and updating of project documentation.
- HIE HL7 Tables Meeting – Attended meeting with Microsoft to generally discuss the HIE requirements for sending HL7 Table Values for “coded” fields on Thursday 10/27.
- HIE ITS Reports Gap Analysis – Attended and participated in this meeting to discuss ITS Report gap analysis findings and action items on Thursday 10/27.
- Doctor EMR Interface Kick-off Meeting – Attended and participated in this meeting with multiple EMR Vendors on Thursday 10/27.
- HIE Patient Consent Requirements Meeting – Attending this meeting to discuss Patient Consent and Opt-in / Opt-out requirements for HIE early adopters whose EMR system is Meditech on Friday 10/28.
- Integration Team Support – Per request from the team, completed log level report for the PACS_CONV schema on AEGT023 to aid the process of clearing disk space for the Upgrade project parallel testing. Worked to troubleshoot connectivity and timeout issues that we are experiencing with the reports interface connection.
- HIE ADT Gap Analysis – Completed series of updates to the ADT Gap Analysis document based on discussions and research that I completed for the production ADT message content. The goal is to close out each of the issues and provide definitive responses to HIE by COB 11/1.
- HIE ITS Gap Analysis – Completed final updates to the ITS Gap Analysis document and shared with HIE prior to our meeting with them.
- Received Procedures extract from Jyoti and updated the content to include references to the associated HL7 fields for the Procedure dictionary data items (Category Mnemonic and Procedure Mnemonic)
- HIE LAB Gap Analysis – Worked at length to discuss and agree on our combined response document to HIE including completion of analysis. Once the document was complete, shared with HIE in a detailed email describing the current status of our side of the gap analysis, the meeting for LAB is next Monday 10/31.
- HIE LAB e*Gate Transformation/Routing Rules Development – Completed e*Gate configuration and coding changes to incorporate the standard HL7 ETD for Meditech Lab Result messages as a replacement for the HL7GenericInEvent that was used for the initial deployment of pass through business rules. Completed build of all collaboration rules to send to MCHIE the full complement of HL7 segments present in Lab Result messages (MSH, PID, PV1, IN1, OBR, OBX and NTE).
- HIE Connectivity / VPN Issue – On Tuesday morning 10/25, identified connectivity problems that actually first occurred Friday 10/21. Shared this information with Microsoft and worked at length with their VPN technical resource and team members on our side to attempt to troubleshoot these issues. On Saturday 10/29, installed the Microsoft Network Monitor software on ACN016 and implemented packet capture hoping to use the evidence to compel the network team to complete a VPN tunnel rebuild on Monday morning 10/31. As of Saturday evening 10/29, the problem was not resolved, so worked to unload the message backlogs from e*Gate so that they can be re-sent later when the connection is back up.
- Doctor’s EMR Interface Project – Per request, pulled together sample HL7 messages from production (Doctor as Ordering Provider) for a lab result, a radiology report and a departmental report. Completed manual changes to each sample to de-identify all patient data inside the message. Subsequently, delivered detailed email to the entire team with the following attachments: VPN Request Form, production sample messages, ITS Reports Dictionary extract from PSMH and ITS Procedure Dictionary extract along with a list of next steps required for the team to move forward with the build and testing.
- HIE HL7 Tables and Meditech Dictionaries Spreadsheet – Completed a series of updates to this document based on the work regarding the overall issue of HL7 Table and Meditech Dictionary requirements. Added details on HL7 data types associated with each coded field, added column with detail on whether descriptions (for mnemonics) are currently included in the HL7 messages and added “Microsoft Comments” column based on feedback received for each “coded” field.
- ITS Reports Interface – Completed test of first report message all the way into Meditech by taking the raw message delivered adjusting to meet Meditech ITS Inbound HL7 reports requirements. Based on analysis of the messages, provided with a couple action items on the remote facility side. First thing was to have her adjust the format to use single OBX rather than multiple OBX segments and also to ensure that the Meditech Patient Account Number (PID.18) is returned in the same field for reports returned from the remote site.
- Continued work on creating Objects Plus functionality to allow Epiphany EKG application to show up in a tab in SCM.
- Calls/correspondence related to Epiphany project.
- Post ePI activation calls and correspondence.
- Created technical conversion specifications for visits (from Oacis), lab (Labcorp from Practice Partner), lab (from Oacis), Pathology (from Oacis), Micro (from Oacis), and RAD (from Oacis).
- Conducted technical reviews for visits and Labcorp conversions.
- Writing Perl script to extract Labcorp results from Practice Partner to a flat file.
- Performed ADT message testing on Responder, Formfast, and Ecin ancillary systems
- Debugged and modified mapping file to handle Allergy Descriptions from Meditech
- Debugged X12 5010 278 message map with Centura to handle empty fields.
- Updated system documentation
- Meet and greet, submitted hospital documentation and orientation forms.
- Performed billing message analysis on GE/IDX DFT messages and Epic DFT messages.
- Epic/Hospital interface team meeting, discussed interface testing and status updates
- Billing Kickoff Team meeting to discuss professional billing interface from GE/IDX to Epic
- Documented Field by Field analysis of billing messages.
- HIE Internal LAB Meeting – Attended meeting to generally discuss the impact of the Meditech 5.6 upgrade on the HIE project.
- Integration Team Support – Completed a health and wellness check on the production HIE schema in production after the re-boot of the ACL017 (Update2) cluster over the weekend. Worked at length attempting to resolve the “phantom” subscriber issue that was eventually identified and fixed (TEST system was connecting to PROD IQ Manager). Worked to resolve issue where Meditech stopped writing census file extracts to e*Gate for the Medmined interface.
- Doctor Interface Project for PCMC – Received email requesting that I provide a status for the project. Completed some research into old emails and correspondence with Doctor’s EMR vendor representative. Subsequently, responded with a detailed agenda for a new project kick-off call listing the up front steps to define the scope of the project (list of interfaces) and the need to get things rolling with the VPN setup. Stressed the importance of defining scope during the kick-off call and also shared Meditech HL7 interface specifications for ADT, LAB and ITS reports.
- Meditech 5.6 Upgrade Project – Worked at length to resolve the space issues for AEGT029 (CS and CS_SouthernRegion schemas) by identifying via an e*Gate modules summary report listing all modules per schema that is currently logging at “TRACE” level. Also, worked to clear down the IQ Manager “stcms” folders for all 18 IQ Managers for the 2 schemas while adjusting IQ Manager DB settings as necessary to save space on start up and to ensure that the IQ Manager data was being written to the same host as the defined participating host for each schema.
- HIE Lab Mnemonics Extract Research – Researched the 5 fields that HIE has requested be included in the Meditech LAB/MIC mnemonics extract that they require as part of the LAB interface set up / configuration. Identified that 3 out of 5 fields can be supported right out of the gate which includes Lab Test Mnemonic and Lab Test Name and Lab Test Category (Department in Meditech). The remaining 2 fields will require some research and feedback to see if they can be supported. Requested that feedback and currently waiting on that feedback.
- HIE HL7 Table Translations and “Coded” Fields Research – Based on the request from HIE to provide HL7 Table translations (from Meditech defined codes) for Race, Religion and Relationship, fired off another set of questions to HIE team to see if this extends to other HL7 Table “constrained” fields as defined in the HIE HL7 Specification document. Based on the feedback from HIE, created a spreadsheet that lists all of the HL7 Table “constrained” fields (“coded” fields) in the HIE specification for all 3 data feeds (ADT, LAB and ITS). Subsequently, filled in all HL7 Table information for each field (20 total across 3 data feeds). The feedback from HIE provides us with two options for each of these fields which are: Translate Meditech codes to HL7 Table codes and then maintain that translation over time OR share with HIE the associated Meditech dictionary or list of codes/descriptions for non-dictionary “coded” fields (e.g. Account Status). The team and I discussed my findings and agreed that we needed management level review and approval before making decisions on which option to choose for each field with ongoing maintenance being the longest poll in the tent.
- HIE ITS Gap Analysis – Completed ITS Gap Analysis response document to HIE based on their short list (2 total) of questions regarding the content and format of ITS ORU Report messages. Included in the document detailed descriptions for each field that is supported as “repeating” within the Meditech ITS report message format. Also, provided HIE with the ITS Report Dictionary extract leaving only the ITS Procedure Dictionary extract. Requested that Jyoti provide that extract once I got confirmation from HIE that they would need it.
- HIE ADT e*Gate Transformation/Routing Rules Development – Using the pass through placeholder BOB, began e*Gate collaboration rules level coding of the full blown business rules for HIE ADT messages using a Meditech HL7 ETD for ADT messages instead of the “HL7 GenericEvent” ETD that I used to build out the shell weeks ago. Will be implementing a series of transformation / routing rules based on the results of the ADT Gap Analysis meetings and review (e.g. filtering out empty UB2 segments, normalizing invalid SSN’s to the designated unknown SSN format, etc…).
- Continued post activation support and calls for ePI
- Created custom tab in SCM for Epiphany cardiology URL. Next steps are to add browser control and confirm it works by directing to bogus URL
- Upon receiving access to the Epiphany application, confirm local access and look for test patients
- Work with the TSC at Allscripts to allow access to URL from SCM
- Add patient context sensitivity to browser application so correct EKG pulls up for the right patient
- Test new custom tab
- Continued work becoming familiar with Practice Partner underlying tables for backload to Epic
- Learned that visit backload now in scope as well as re-prioritization of interfaces
- Research on converting HTML documents to raw text for conversion
- Research Practice Partner lab result configuration in prep for conversion to Epic
- Due to large size of tables containing conversion data, considering options for indexing to allow them to be processed as quickly as possible
- Attended Sedation Integrated Team meeting to present the use of Epic Anesthesia for the sedation workflow.
- Met with Epic to discuss plan for Cardiac Anesthesia validation sessions.
- Cardiac Anesthesia Validation Session held on October 18th.
- Met with Doctors to design content for medication preference lists and the ROS/Physical Exam/Anesthesia Plan SmartForms.
- Worked with vendor MicroAge to obtain demo touchscreen monitors in 19” and 20”.
- Attended meeting with Epic to discuss questions surrounding SmartForm build.
- Met with Interface Team and Ancillary Application Team to discuss the requirements needed for a middleware vendor to integrate carts and vents with Epic Anesthesia.
- Worked on build of Epic Anesthesia Navigators and Post Op Note.
- The ASAP team created new sections in the Meds, Lab, and Radiology preference lists in EPIC to reflect the categories that the physicians requested. We also created excel spreadsheets showing breakdowns of the categories and missing items. We will be presenting these next week.
- Completed a draft HOD build tracker and started to look at the test scripts needed to support the HOD workflows.
- Reviewed all project documents new and old related to OpTime
- Reviewed all current and future state workflows
- Drafted project documents
- Project Plan
- Issue document
- Risk document
- EPIC week to week
- Build Document
- Workflow tracker set up
- Testing scripts reviewed, plan to convert for facility, draft tracker in place
- Several meetings to discuss scope of OpTime for southern location, future meeting will be set up with key leaders to discuss scope to include the following
- Implant/Explant documentation and tracking
- Implant and SUP charging set up and configuration
- Use of Inbasket Preference card pool messages
- Navigator changes PRE/POST and Intra-op to support smoother workflows, remove unnecessary activities to declutter. Improves workflow and assists with training
- Implement log scripting to speed up documentation workflows for quick cases
- Implement PNDS to support perioperative care plan process.
- Attended physician validation session for the Orders Cosign Deferment Workflow.
- Met with Orders team clinical staff regarding the use of the Code Narrator for the Patient Code workflow.
- Worked on mapping EAP and LQL records for PT, OT, SP, RT, and Consult Orders for department validation.
- The team participated in a cross-team meeting regarding sedation workflow development and is comfortable with the current progress. Although the sedation workflows are not yet fully complete, this week we have been able to begin build efforts. A detailed (item-level) build tracker was developed and build for imaging and modality departments (DEP) was started in the tracker. The build for the new records will be provided to the ADT team, and once the records are created the Radiant build can be rapidly completed from the tracker. Planned build for next week is modality SER records.
- In progress FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS (Testing)
- Performed ADT message analysis on Obix, Paml, Medquest and Zotec ancillary systems
- Performed ADT message testing on Responder, Formfast, and Ecin ancillary systems
- Created javascript to extract Message Control ID to help with message testing and management
- Created javascript to count the amount of RXC message segments in Pharmacy messages for filtering, improving message throughput.
- Debugged and modified conditional message filtering with Centura, discarding Adt messages for Pocket Scripts
- Updated system documentation
- HIE Patient Consent for PHI Meetings – Attended two meetings with management to discuss HIE requirements for opt-in / opt-out and also patient consent for highly confidential patient heath information (HC PHI) on Friday 10/14.
- Integration Team Support – Completed synchronization of all components and associated collaboration rules that I’ve deployed for the Physician Integration schema. Completed this work with 5.6 Upgrade parallel testing preparation.
- HIE LAB Gap Analysis Work – Documented in detail each HIE Issue/Question that was discussed at the LAB Gap Analysis meeting with HIE team. Subsequently, received list of question/items from the HIE team for those items that we were not able to discuss on the conference call. Completed detailed review and research for each item. Added updates for each item with proposed research and solution paths including detailed documentation for identifying the culture, organisms and antibiotic susceptibilities within a given Meditech HL7 ORU Microbiology Result message with comments and bolded data pieces embedded. Shared this response document with the team looking for feedback and to finalize the document contents and proposed solutions. Currently, still waiting on that feedback from the team. In between, have responded to a couple requests from the team. One request was to research the EICU processing for “D” status result OBR/OBX groups, so completed that research by isolating a production example of the “D” status and shared the input and EICU output with Jan. The second request was to pull together “complete” HL7 messages based on the 13 LAB question/issues posted by HIE, completed that request and shared the messages with Jan.
- HIE ADT Gap Analysis Work – Completed updates to the ADT Gap Analysis Response document with detailed field name and usage information gathered for the UB2 segment data fields, based on researched of production messages for the A34 and A35 message issue where the associated MRG segment is empty/null and also pulled together the HL7 Tables (from the HL7 v2.5 Standard documentation) for Race, Religion and Relationship based on the HIE report that they require HL7 Standard Table values for the these 3 fields. Shared the document with the MCHIE team and notified Rich of the issues that still require some research and possible testing (5 total) with an ADM/ABS subject matter expert from the IT clinical team.
- HIE Patient Data Security Research/Discussion – Worked at length directly with Rich and separately to complete research to agree on our interpretations of the HIE requirements language for the “Opt-In / Opt-Out” level requirements and the “HC PHI” level requirements associated with Patient Consent. Also agreed that Rich’s idea to support a “Confidential” flag within all ADT, Lab Results and Radiology/Department Reports messages would be the ideal solution if it is possible, research of the solution is pending. This “Confidential” flag is already supported within the ADM workflow at the site and is present in the HL7 ADT messages, so looking to extend that for LAB and Reports.
- LAB Results Interface – Completed development, unit testing and integrated testing for the LAB Results interface from Meditech to client’s remote location based on the detailed specifications for constructing OBX segments for ORU messages to Standing Stone. Completed series for successful tests for INR results using production messages with patient information updated to point to test patients already in Standing Stone from ADT interface testing.
- Continued provisioning of Practice Nodes on Hospital Node.
- Continued deployment & support of DropBox for independent ambulatory practices.
- ProAccess: Org & User Maintenance for Emergency Departments (GVCH, SYCH, SBCH).
- DropBox: Installed iNexx Platform; additional research with SMEs on configuration for routing by facility
- ProAccess 5.3 Upgrade: Controlling Phase with validation of Medicity PM and the fixes in last CERT deployment: lab data displays, updated logo for storefront/login page, PA Reports Upgrade (display of Result comments), HCS Composer, MHCW Interface Routing & Workqueues; tracking & escalation of testing issues with Medicity.
- Advance Directives Interface: Controlling Phase and continued testing with vendors; tracking & escalation of testing issues.
- Greenway Gateway: Executing Phase – status call with Medicity HL7 Interface resource; escalated Phase 1 project risk of contracts issue with Cottage; continued completion of Practice Planners for eHP practices for Phase 1 HL7 interfaces.
- Sansum-PDL Orders Interface: Controlling Phase – continued integration testing & validation by PDL & Sansum; continued monitoring of project status and tracking of deliverables.
- SB Cardio-PDL Interface: Controlling Phase – Cottage & PDL performing validation with Prime Clinical & SB Cardio; continued monitoring of project status and tracking of deliverables.
- Medicity Training: Continued training of facility staff & PDL staff on DropBox, EHR Interfaces, and ProAccess; DropBox training for external practices.
- Project Management: PM related correspondence with Medicity, other vendors as well as medical facilities.
- Provided onsite ePI activation support
- Began work on Objects Plus development to view EKGs in SCM
- Completed HL7Encrypt2Lvl specification.
- Completed HL7Decrypt2Lvl specification.
- Review of Practice Partner database set up and Epic backload specifications
- Worked on parsing and concatenating RTF files
- Assisted in the finalization of Hospital Codesets for preparation of ProAccess.
- Contacted EMR vendors negotiating “best price” for interfaces for results delivery balancing EMR responses with historical best pricing with Medicity.
- Testing phase with Allscripts PRO Vendor to align MSH segment values and patient matching. Clean processing with no issues.
- Assisted physician with troubleshooting specific results flow to his practice though the Medicity Grid. The discovery phase found specific messages were being held up in the EMR and not delivered to his folder. Contacted EMR and discussed the issue and our findings. EMR corrected issue with no further problems by the physician.
- ADT Interface – Completed a series of test registrations in DB.TEST while working client remote site to address issues that were reported with the initial set of integrated test patients. Based on their feedback, had to modify the e*Gate routing and transformation rules to only send a single NK1 segment, default the value “EP” in NK1.7 for that single NK1, filter out all ADT events except the A01, A04, A05, A08 and A18 (translated from A34) and to filter out all OBX segments from output to their location. After making the changes, completed series of detailed unit tests to ensure the changes functioned as designed. Subsequently, completed another set of test registrations in DB.TEST and to confirm that the new test patients filed properly.
- Created site specific Interface Requirements document for this interface and completed implementation within e*Gate production environment. Sent out the standard email to the interface team regarding the go-live including the requirement document, updated the downtime list and provided information on the new event type to track in the Queue Status scripts.
- Completed production implementation of the ADT interface to Project 1A for the final 3 ministries. This e*Gate build was extensive, requiring a new BOB and File e*Way for each ministry and a new JMS bridge e*Way for an interface to bridge ADT messages to the CS Schema for delivery to Project 1A on a single port / feed. As part of the process, first built new modules in the conversion environment, using the same e*Gate routing/transformation code from the first 3 ministries and followed this up with the same build steps in the production environment. Once the process was complete, sent the standard notification email to the Integration Team to address the downtime list, support information and new event types. Also, sent an email to the Project 1A Team notifying them of the new data feeds for the final 3 ministries.
- Cardiology ITS Reports Interface – Worked to support troubleshooting emails with the IT support team. The issue reported was the same issue from the past where they fail to return an ACK in a timely fashion and e*Gate re-sends the previous message which results in duplicate reports within Allscripts. Ultimately, bumped the read timeout for ACK’s from 10 seconds to 30 seconds and sent out detailed email to all interested parties that we would keep an eye on things, but to expect this issue to occur if Allscripts does not send an ACK back within 30 seconds of message receipt.
- Interface Team Support (1 hour) – Based on emails regarding issue with messages backing up for recently implemented JMS “Bridge” e*Ways. Researched the issue and provided log file evidence that the backups were related to inadvertently triggered collaboration shutdown/restarts based on users accessing the shared collaboration rule “crPassThru”. Shared my findings in email to the team, instructing them to take care when working within the production environment with shared components like “crPassThru”.
- Completed gap analysis for the ADT (including ABS generated BAR^P01 messages) interface between Meditech and HL7 Specifications including some additional updates to the “Site Health Comments” section of the Meditech HL7 Specifications. I documented the gap analysis information via Word Comments added to the MCHIE provided “Default Message Set” HL7 ADT Interface Specification. Notes were added at the field level to document the fields that are not supported/sent by the Meditech ADM/ABS outbound HL7 interfaces. Also, general notes were added regarding supported event types and in some cases field level value notes were included for critical fields (e.g. Meditech Patient Type Values for PV1.18).
- ePI activation preparation and calls.
- Review and finalize ePI Administration documentation.
- Began review of items to be backloaded into Epic.
- Analysis of source tables containing data to be backloaded.
- Meetings regarding backload and Radiology interface.
- Finished coding the SQL tables to maintain proper procedure codes for Radiology orders and tested it
- Finished testing Nuclear Medicine exams
- Worked on finishing up Radiology Charge route
- Medicity 5.5.1 Workplan Completed
- Educated technical analyst on the project management and organization’s processes for technical deployments.
- Identified project risks and began developing mitigation plan.
- Advised hospital staff on course of action for issues identified throughout the week.
- ADT Gap Analysis Meeting – Attended this meeting on Friday 10/7 and took detailed notes on each issue that the HIE reported.
- Received report that the “archive” piece of the e*Gate solution for one site was not working at all. Completed detailed follow up research/testing and discovered that an additional collaboration was needed to support the SFTP component of the solution. Completed creation of the new collaboration which isolates the SFTP processing and then modified the existing collaboration to only handle the creation of the file itself. Once these changes were complete and testing was successful (including archive of files) had to complete some work to remove older versions of the e*Way’s and collaboration rules in order to ensure that TEST and PROD were synchronized with the latest copy of the interface solution. Subsequently, worked to utilize the “proxy” SFTP server that I defined on ACN013 for this and future testing and worked with her to help her understand how to the use the “proxy” SFTP server.
- LAB Gap Analysis – Completed gap analysis for the LAB Results (currently LAB and MIC only) interface between Meditech and HIE HL7 Specifications including some additional updates to the “Site Health Comments” section of the Meditech HL7 Specification. I documented the gap analysis information via Word Comments added to the HIE provided “Default Message Set” HL7 Lab Results Interface Specification. Notes were added at the field level to document the fields that are not supported/sent by the Meditech LAB Results outbound HL7 interfaces. Also, general notes were added regarding supported event types and in some cases field level value notes were included for critical fields (e.g. Meditech Lab Result Status Values – OBR.25 / OBX.11).
- HIE Project – ITS Gap Analysis – Completed gap analysis for the Radiology Reports (currently LAB and MIC only) interface between Meditech and HIE HL7 Specifications including some additional updates to the “Site Health Comments” section of the Meditech HL7 Specification. I documented the gap analysis information via Word Comments added to the HIE provided “Default Message Set” HL7 Radiology Reports Interface Specification. Notes were added at the field level to document the fields that are not supported/sent by the Meditech Radiology Reports outbound HL7 interfaces. Also, general notes were added regarding supported event types and in some cases field level value notes were included for critical fields (e.g. Meditech Report Department/Type – OBR.20 / OBR.21).
- HIE Project – Created document to list all of the issues reported by HIE in the ADT Gap Analysis meeting along with the solutions that were discussed and/or proposed for each issue.
- LAB Interface – Completed requirements gathering with the team and received confirmation from them that we need to send only lab results associated with the following Meditech lab test mneonics “PT” and “PROTIME” which are the “Coumadin” tests within Meditech. Began developing the e*Gate components that will process lab results (already bridged from EICU to CS schemas in production) based on the requirements for OBR and OBX from the HL7 Interface Specification document.
- Received report regarding the format of files being incorrect for Meditech extract files for the WE interface. Subsequently, worked to open a heat log with an assignment to a knowledgeable resource to see if he can solve the issues with changes to the extract. If this path doesn’t work out, I will have to modify e*Gate to “transform/translate” the data according to the issues reported and this will take some time because it is currently a pass through interface.
- Continued testing and modification of custom command setup
- Continued testing and modification to Web Account Creation custom cache routine
- Updated documentation on custom command design and cache routine
- Custom Command/Cache routine communicated with the .Net application
- Communicated with Epic about command setup and data availability
- Migrated changes to testing custom cache routine back from TST to POC
- Migrated changes to Web Account Creation custom cache routine back from TST to POC
- In progress FTP log/DB logger to capture Financial transaction between Meditech/Lawson/LSS (Testing)
- Added additional data to the FTP Log for file transfer detection
- Added functionality to all ADT routes to provide a log of all messages processed
- Debugged Meditech to Computrition Javascript filtering.
- Tested Pyxis javascript Adt filter
- The ASAP team has started configuring the preference lists to closely match the preference lists that were used in. We are also researching build design requests from the Ops team and preparing for the upcoming build.
- This past week I went back over all of our workflows and started to look at the gap analysis documentation in detail to decide assignments of build work. Held a team meeting on Friday to discuss plan to attack the build.
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