Raymond D. Aller, MD
Michael Weilert, MD
Cerner becomes first global distributor of SNOMED CT
The College of American Pathologists has signed a five-year agreement with Cerner Corp. that licenses SNOMED Clinical Terms core content to Cerner for unlimited global distribution, making Cerner the first global solutions provider of SNOMED CT.
SNOMED CT is the core clinical terminology within the Cerner Controlled Medical Terminology knowledge infrastructure for Cerner Millennium health care information technology solutions.
With a SNOMED CT-driven electronic medical record, such as Cerner Millennium, multiple terms for the same clinical condition, such as Goodpasture’s syndrome, lung purpura with nephritis, and pulmonary renal syndrome, are translated into a single clinical concept. This allows clinicians to consistently capture, share, and aggregate health data across specialties and sites of care. With SNOMED CT as its core clinical terminology, Cerner CMT improves clinical documentation and ensures the correct diagnosis is captured for billing.
SNOMED CT is a core terminology comprised of clinical concepts, terms, and relationships that help represent clinical information across the continuum of health care. It offers more than 957,000 English language descriptions or synonyms.
In 2003, Cerner became the first health care technology supplier to deploy SNOMED CT within its electronic medical record. This decision was affirmed shortly thereafter when the CAP signed an agreement with the National Library of Medicine, making SNOMED CT core content readily available in the United States. Also in 2003, the National Committee on Vital and Health Statistics recommended SNOMED CT to the secretary of the Department of Health and Human Services, Tommy G. Thompson, as the patient medical record information terminology standard.
"As a company committed to transforming health care across the globe, Cerner is a strong advocate for clinical data standards to ensure data interoperability, comparability, and quality," says Paul Gorup, co-founder and senior vice president of Cerner. "Only data structured and codified in a meaningful way via an accepted, standardized health care terminology such as SNOMED CT can provide the foundation for effective information management, decision support, and clinical outcomes measurement and improvement."
Adds Franklin R. Elevitch, MD, chair of the SNOMED International Authority: "Multinational software suppliers like Cerner will play an increasingly major role in creating value by implementing terminology standards. As health care organizations and governments worldwide assess the infrastructure requirements, the choice of a terminology standard will have a profound impact on system interoperability, comparability of data, computerized order entry, workflow, and decision support.
"Through this agreement," says Dr. Elevitch, "SNOMED CT brings value to Cerner’s
clients around the world."
SNOMED International Authority,
New FDA rule intended to reduce transfusion errors
A new FDA rule requires machine-readable information on blood and blood component container labels to help prevent blood transfusion errors and accidents.
The rule, which took effect April 26, requires that all blood and blood component container labels contain FDA-approved machine readable symbols identifying the collecting facility, lot number relating to the donor, product code, and the donor’s blood group and type.
The new rule also requires bar codes on prescription and over-the-counter drugs administered to patients in hospitals.
The new regulation should prevent 500,000 adverse events and transfusion errors over 20 years, says FDA commissioner Mark McClellan, MD, PhD. Furthermore, the labeling requirement for blood and blood components should have little effect on manufacturers of blood and blood components, the FDA reports.
The FDA stated in the introduction to the final rule that, "we could not identify a manufacturer of blood and blood components intended for transfusion that does not currently apply bar-coded information that includes information required by this final rule. The final rule does not specify a particular bar-code standard for this market segment. Therefore, we do not believe this rule will pose any incremental cost to this industry."
"I think as far as blood goes, many [hospitals and blood centers] are already doing this, so I don’t think it’s a major deal for them," adds Joyce Sensmeier, director of special services for the Health Information Management Systems Society. "It just confirms the importance of preventing errors and puts some teeth into making sure that it gets done."
Hospitals and other suppliers of blood and blood components conducting business before the effective date of the rule will have two years to implement the regulation, which has the support of the American Association of Blood Banks.
Some members of the blood transfusion industry, however, believe the new regulation can’t be fully effective until patient identification incorporates bar codes as well. "The real software development need is to match the unit with the patient at the bedside," says Suzanne Butch, MA, MT(ASCP), chief technologist for the blood bank and transfusion service, University of Michigan Health System, Ann Arbor.
"Once the hospitals have a system to generate a bar-code label, I think the next step to this will be for the patient’s identification to be bar-code readable. But you have to have an infrastructure first," adds Ira Shulman, MD, director of transfusion medicine at the Keck School of Medicine, University of Southern California, Los Angeles, and Web master for the California Blood Bank Society e-network forum. "In the long run," he says, "this could be an incredible improvement in safety."
CLMA/ASCP meeting offers a peck of products and news
CAP TODAY contributing editor Hal Weiner attended this year’s Clinical
Laboratory Management Association/American Society for Clinical Pathology conference
in March. Following are snippets of what he learned and observed.
With more than 160 educational sessions, 150 vendor booths, and the NCAA basketball tournament next door, the CLMA/ASCP 2004 conference and exhibition in Atlanta scored.
Getting the conference off to a dynamic start was breakout session speaker James Nichols, PhD, director of clinical chemistry for Baystate Health System, Springfield, Mass. Dr. Nichols presented the results of several studies that compared the error rates between various point-of-care testing devices and their accuracy. His finding: The difference between the results of various glucose meters was as high as 100 percent. The studies clearly showed that POC testing devices should not be used for diabetic screening, Dr. Nichols said.
Similar differences were noted for other types of POC testing devices. A lack
of clear standards is one factor that contributes to the discrepancy, Dr. Nichols
said. Consequently, the National Academy of Clinical Biochemistry (www.nacb.org)
will be publishing a guideline addressing this issue early next year.
In addition to the problem of meter inaccuracy, many errors occur in the pre- and post-analytical stage, but most can be corrected with appropriate training and quality improvement monitoring, Dr. Nichols stated.
Several CLMA/ASCP presentations focused on the financial component of operating a laboratory. Managing modifiers and maintaining procedures that are consistent with current rules were two of the topics discussed. Common messages from these sessions were know your net revenue and send a clean claim the first time.
Mary Kay, MS, MT(ASCP), director of patient financial services at Dukes Memorial Hospital, Peru, Ind., described the key steps that a laboratory manager can take to maximize net revenue. These include implementing effective denial management and charge master audits, communicating regulatory changes in a timely manner, and developing a good relationship with the hospital billing department.
On the exhibit floor, attendees were offered a chance to peruse a variety of
new products. Last year’s "coolest" new technology, the Nikon Coolscope digital
microscope, was displayed with its latest capability, which is the ability to
scan an entire slide image and view any part of the slide at high resolution
at a later time. Nikon is using virtual microscopy software from Bacus Laboratories,
which allows a slide to be scanned in 15 to 30 minutes and then makes it available
for high-resolution viewing and printing. The cost of Coolscope with the new
software is $25,000.
Park City Solutions offered an answer to laboratory directors who operate an outreach business and
are constantly being asked, "How do you compare to our competition?" The company’s
Empowerlab benchmarking outreach module will provide a peer comparison of key
indicators, such as net revenue per requisition, calls per client service full-time
equivalent per day, and average new net sales per month per sales representative.
The best part of this service is that the first report is free. To populate
the database, Park City Solutions is offering to provide the first report at
no charge to anyone who participates in the survey. The subscription charges
will be $3,000 per year for quarterly reports or $2,000 for semi-annual reports.
For additional information, contact Daniel E. Rajkovich at email@example.com.
Also offering a free trial is Braley Consulting Services LLC.
The company will provide a copy of its Management Tracker software for a six-month,
no-obligation trial. Management Tracker manages communication between multiple
individuals, committees, clients, projects, or other activities. For additional
information, contact Gary Braley at firstname.lastname@example.org.
For those laboratories that have not found a simple solution for dealing with
the troublesome client who never seems to receive the lab report or who constantly
misplaces it, ProxyMed may have an inexpensive solution. The company’s external report tracker technology can store, print, and manage up to 2,000 reports in its memory. It can provide
the lab with such information as when a report was received, when it was printed,
how many pages were printed, and if there were errors.
When combined with a ProxyMed printer, the technology can provide positive proof of delivery. Furthermore, the device can be easily moved from one site to another and used as an audit tool. The external report tracker product costs $500.
Several vendors exhibited new or updated billing/accounts receivable systems
specifically tailored for the laboratory market. Telcor demonstrated its new outreach billing module, which has been specifically designed for the laboratory to manage the entire outreach revenue cycle, including tracking of key indicators, and includes a service to maintain all national and local
CCI (Correct Coding Initiative) and other edit rules.
Medical Data Processing announced that it will be marketing a new browser-based billing/accounts receivable
product later this summer, and MediSolutions demonstrated its new MediAR+ system. (See CAP TODAY’s billing/ accounts receivable
systems survey, pages 28-35.)
Korchek enters agreement with Mediware
Korchek Technologies has reached an agreement with Mediware Information Systems to become a certified solutions partner.
The agreement allows Korchek to provide services to Hemocare and Hemocare LifeLine
users in regulatory compliance issues.
Mediware Information Systems,
New system for accessing genetic information
Cerner Corp. has developed PathNet Helix, a clinical information technology solution that allows genomic information to be stored in an electronic medical record.
PathNet Helix is built on Cerner Millennium architecture and seamlessly interfaces with other PathNet and Cerner solutions.
The product’s case documentation capabilities permit laboratories to record
data gathered while results are generated. Once the results are available, PathNet
Helix uses bioinformatics coded values and presents the findings using standardized
terminology. Helix also includes features to simplify sample tracking and to
reduce the amount of paper needed to store information captured during routine
SCC Soft Computer releases workflow engine
SCC Soft Computer has released SoftWorkflow, its workflow engine that includes a clinical outreach management package.
SoftWorkflow allows the user to set customized standards in processes, such as physician order entry or results delivery, and is accessed from a single, Web-based user interface. The product also contains an advanced graphical process design feature that is compatible with Microsoft Office documents.
The clinical outreach management package is made up of a customer relations component, which tracks customers’ incoming calls, requests for service, and problem resolution; a courier tracking component to dispatch and track courier requests, specimens, and supplies; and an inventory management component to manage such supplies as specimen tubes, containers, requisitions, and forms.
SCC Soft Computer
IDM introduces latest version of Surround
Information Data Management recently released Surround version 4.0, an open laboratory system designed to manage test results for blood and plasma centers.
Features incorporated into the latest version of Surround include full support of sample identification using the ISBT 128 format, configurable testing worksheets for tests performed manually, ability to reset transfer flags at will, animated icon indicating transfer progress, improvements to the fax transfer method, and additional system reports to aid in data retrieval and analysis.
IDM reported that Rhode Island Blood Center, Providence, has already signed
a contract to install the Surround 4.0 system.
Information Data Management,
Misys Healthcare Systems has signed an agreement for its Misys Pharmacy and Misys Insight clinical information systems with Massachusetts General Hospital, Boston. Both products are part of the Misys Optimum clinical information systems portfolio.
Misys also announced that two private laboratories in Ireland have contracted
for its CoPath Plus anatomic pathology system. Those laboratories are Bon Secours
Clinic in Cork and Blackrock Clinic in Dublin.
Misys Healthcare Systems
Meditech has signed a contract with Stellaris Health Network to install its client/server health care information system in Stellaris’ four hospitals.
Stellaris is the corporate parent of Lawrence Hospital Center, Bronxville, NY; Northern Westchester Hospital, Mount Kisco, NY; Phelps Memorial Hospital Center, Sleepy Hollow, NY; and White Plains (NY) Hospital. Stellaris also provides ambulance, municipal paramedic, and other transportation services through Westchester EMS.
In a separate announcement, Meditech reported that it will implement its advanced
clinical system and laboratory information system at Greater Baltimore (Md.)
Medical Center. Meditech
Dr. Aller is director of bioterrorism preparedness and response for Los
Angeles County Public Health Acute Communicable Diseases. He can be reached
at email@example.com. Weiner is president
of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at hal@
weinerconsulting.com. Dr. Weilert is director of laboratories, Community
Hospitals of Central California, Fresno. He can be reached at firstname.lastname@example.org.