1. Type of Queries/Advice:
2. Workflow Enabled: 
3. Configurable Logic: 
4. EHR Embedded: 
Beware of Unproven Competitors:
Martin Coyne, MD, MS CMO Hiteks
Gerry Petratos, MD, CEO Hiteks
How are Clinicians like doctors, nurses, pharmacists, and others directly involved in patient care doing? From many reports, neither Clinicians nor their supporting administrative staff have fared well in the past decade—but don’t blame the Electronic Health Record (EHR) or downward wage pressure.
When you evaluate different segments of Clinicians, the ones who practice in a technologically rich environment for workflow simplification, compared to those lacking productivity tools, treat their patients more effectively with less frustration. Clinicians who have access through fewer steps to timely educational information and treatment reminders in context to their patient can provide better evidence-based medicine (EBM). EBM such as new guidelines from medical societies, applied efficiently during care, translate to improved provider utilization of the EHR, clinical decision-making, and patient engagement.
The question of how to best apply technology to reach high-productivity amongst Clinicians makes the difference. Most medical practices and hospital systems in the United States are mandated to use the EHR along with additional decision support capability, with other countries following suit. While the EHR provides the digital foundation and framework into which workflow-based information services can be integrated and delivered to the Clinician, early experiences using the EHR have been dismal. Clinician resistance is attributed to the lack of intuitive screens requiring many steps to accomplish what was previously done with the swipe of a pen and paper.
The first stage of the digital revolution in US healthcare, which comprises 16% of the economy, was defined by the universal implementation of the EHR. This digital tool was viewed by Clinicians as impeding their workflow and by patients as interfering with the physician-patient interaction. In addition, addressing quality of care metrics and increased medical costs has been limited even with continued medical science advancement of disease treatments.
Heart disease is a good window into the future of global healthcare. According to the CDC, heart disease is responsible for 1 in 4 deaths in the US every year. 6 million Americans have heart failure, with a projected rise to 46% by 2030, driven by obesity and increasing diabetes. Heart failure is the consequence of arteriosclerotic heart disease.
In the last 30 years, the use of statin inhibitors has markedly reduced heart disease. Despite this intervention, heart disease is still the leading cost driver for US healthcare. The reason is that heart disease is now understood to be multi-factorial. Not only elevated LDL but elevated PCSK9, high TMAO, interleukins, and myocardial enzymatic abnormalities are causative. Specific treatments for each of these conditions are now becoming available to physicians and patients. Costs for these new treatments/year range from $15,000 for PCSK9 inhibitors to $250,000 for Tafamidis for cardiomyopathy.
In advanced heart failure, similar advanced and costly treatment options are now offered. These range from Sacubitril, a drug that improves cardio perfusion, to digital monitors of physical signs of heart failure like oxygen and blood pressure monitoring to miniaturized implantable pumps. The key prerequisite for the decision to advance to these next steps is strict implementation of American Heart Association recommendations for generic heart failure medications. This last step requires traditional close attention to patient symptoms, reviewing standard lab values and monitoring drug compliance.
Heart disease is emblematic of the opportunity and challenge for US healthcare. The opportunity is that medical science is rapidly providing insight into the disease and building more powerful treatment options. The challenge is failing to apply or inappropriately applying these advances at the point of care, leading to patient dissatisfaction, increased morbidity and enormous cost overruns.
The second stage of the digital revolution will enable healthcare providers to meet this challenge and fulfill their professional obligations to their patients. This stage leverages the information available in the EHR by presenting it to the clinician in a timely and user-friendly format. The promise of decision support to enhance patient-specific advice in fewer steps, clicks, and screens required to perform the job is now possible through software technology like natural language processing and artificial intelligence.
Technological advances using advanced clinical analytics and cloud computing over the past couple of years have now enabled constant monitoring of patient data to bubble up to Clinicians attention as the most pressing cases requiring action. These innovations can monitor 15-20 data points in the EHR, necessary for modern management of complex conditions such as Sepsis monitoring, as well as Heart Failure, and then present it seamlessly to the physician for evidence-based treatment intervention. This workflow prioritization using the computer to identify the EBM options as next steps in Clinician management optimizes productivity.
The systematic approach of integrating decision support into the EHR workflows focuses Clinicians’ attention on improving population management of disease areas such as Sepsis, Heart Failure, Oncology Biomarker Testing, Back Pain, and others. The response to the initial Clinician backlash against the EHR is not to stop using the EHR, rather to enhance the EHR’s presentation of meaningful patient-specific information to speed decision-making.
The second stage of the digital revolution using advanced software technology to extract and interpret data in the EHR will bring the healthcare industry into the 21st century. In the 20th century, physician productivity was described in a simplistic fashion, using outdated concepts of a worker producing widgets. In this idiom, productivity tools helped a worker produce more widgets/hour, i.e., see more patients/hour. But healthcare globally requires a more modern concept of provider productivity. In this concept, productivity is defined as a tool that enables a physician to gather, review, interpret dynamic, multiple data points in a timely way and apply this to implementation of evidence-based, cost-effective treatment protocols.
This is what the patient wants. This is what the physician wants and must do. This is what society requires. This is what digital productivity software tools like Hiteks provide in the context of individual patient encounters to enhance the EHR workflow experience.
Dr. Martin Coyne
A long experience as a clinical gastroenterologist combined with many years as CEO of large medical groups gave Dr. Coyne the perspective that the physician in real-time at the point of care is central to the multi-trillion dollar healthcare industry. It is this perspective that has informed the development of the Hiteks product portfolio. Experienced Medical Group Administrator (100+ physicians, $100+ million budget) Extensive Clinical Research Experience Published more than 40 Scientific Articles M.D., Boston University M.S. in Medical Informatics from Northwestern B.A. in History from Brandeis.
Dr. Gerasimos Petratos
Gerry Petratos, MD, MS, is CEO of Hiteks Solutions and began his career as an NIH-trained Medical Informatics physician with experience in EHR-integrated decision support systems from Intermountain and the University of Utah. Dr. Petratos has 9 years of experience as the former Global Head of Healthcare Data Analytics at Roche and Genentech.
Ronald M. Razmi, MD, CEO, Kinders
Gerry Petratos, MD, CEO, Hiteks
For years, Big Pharma has marketed its drugs to healthcare providers using a tried-and-true model: running clinical trials, publishing the results in journals, and presenting them at conferences. To drive awareness, brands leverage the evidence in marketing campaigns and physician detailing. Ubiquitous as it’s become, however, this approach has shown mixed effectiveness in commercializing drugs. Its overall return-on-investment is inconsistent, and its effectiveness in new product launches is declining. In many cases, brands underperform because physicians continue to use older and cheaper alternatives, even when a brand offers significant advantages in certain patient populations.
In other cases, several drugs are indicated to treat a single illness, and physicians do not remember the nuances of each alternative at the point of care. Increasingly important are the workflow distractions of the practicing physician; most of their time is now spent in the digital environment reviewing or entering patient data.
Ubiquitous as it’s become, however, this approach has shown mixed effectiveness in commercializing drugs. Its overall return-on-investment is inconsistent, and its effectiveness in new product launches is declining. In many cases, brands underperform because physicians continue to use older and cheaper alternatives, even when a brand offers significant advantages in certain patient populations.
So, how do you overcome this issue? By spending even more on physician education to cover every possible clinical scenario and which treatment to use in it? Perhaps. Improving physician education is always a worthy goal. But brands reach a point of diminishing returns when it comes to information retention: physicians simply won’t remember each detail, in each scenario, at the point of care. eDetailing, in which interactive digital content is made available for clinicians to review on their own time, has drawn a positive response, but information about ROI is still limited. Some of the developments of the last decade offer a new path forward. In recent years, the adoption of Electronic Health Records (EHR) has significantly increased. The newest EHRs have improved functionalities, making relevant clinical information like radiology, pathology, and labs more easily available within the system. Given that clinical workflows are already increasingly digital, there is a natural opportunity to educate physicians about possible treatment options at the point of care, rather than before or after it.
What, then, is keeping point-of-care education and decision support from being widely used today? The answer is that although many things are possible in theory within EHRs, the reality is a long way from this theory. One of the key barriers is the difficulty of interfacing with EHRs. There are many reasons for this. EHR companies create obstacles to prevent access to their proprietary databases. Medical centers, meanwhile, have a high number of competing projects. Finally, nearly 80% of the data in EHRs is unstructured, meaning it must either be ignored or—often manually—converted before it’s accessible and available for analysis.
These barriers would give pause to any Life Sciences company. Indeed, they are some of the
primary reasons that the ROI for such projects to date has been unfavorable.
However, they are not insurmountable, as we discovered when we began to devise a business process and technology solution that could anticipate and overcome them. In fact, our experience building Kinders and Hiteks—two companies that leverage new technologies and enhance healthcare business models—suggests that with the right tools, Life Science companies can build point-of-care solutions that are highly effective marketing vehicles.
Here’s what companies should look for as they evaluate potential partners and systems:
– EHR integration: It’s no secret that the EHR landscape is complex and cluttered. But your installation costs will skyrocket if your point-of-care solution doesn’t easily integrate with the EHRs that are being used at the majority of medical centers. For Hiteks, we first built software that would integrate easily into of most major commercially available EHRs, especially Epic. Then, we fully integrated this into the Epic main engine to become an application for their customers. Because Epic has the largest base of users, this allows us to achieve the wide-scale adoption of new decision support solutions without additional local installation—and create a turnkey solution on the technical side.
– Effective methodology: False positives and irrelevant suggestions are a big problem in POC support. To minimize override rates, make sure your decision support solutions providers can work with you to create decision support that results in highly relevant advice. Our approach includes studying the clinical guidelines and drug labels for the brand, understanding current clinical decision making around the specific illness, mapping current workflows within the EHRs and listing the data used by clinicians to arrive at a management plan, clearly defining the pivotal points in decision process, and building logic to generate reminders at the right time.
– ROI measurement tools: You won’t be able to improve your POC support tools—or make the case for extending them to other brands—unless you keep rigorous track of your results. By combining software that’s fully integrated into the EHR and a robust clinical logic creation methodology, our software can launch point of care decision support reminders quickly and consistently. We then closely monitor engagement with our reminders, using EHR logs to track clinicians’ acceptance of the advice—and any resulting behavioral changes.
Our experience shows that point-of-care support solutions can be highly effective. One pharma brand we worked with had a novel treatment in sepsis. Yet while clinical evidence showed significant advantages for their treatment in certain patients—reducing progression from Sepsis and Severe Sepsis to Septic Shock by 25% and shortening the length of stay by half a day—72% of physicians continued to rely on commonly used antibiotics that have been the mainstay of sepsis treatment for decades.
After careful study of the clinical workflows and clinician decision-making process, we identified all of the key data elements that clinicians use in choosing a sepsis therapy. We then mapped where each one of these data elements resides in the EHR. Using the most up-to-date clinical guidelines and the drug label, we created the logic to generate a reminder in the EHR for the clinicians at the appropriate moment during the management process. This guidelines-based reminder showed the novel therapy as one of the options. It also summarized the reason physicians might select it and the potential associated benefits. Within 3 months, this solution led to 12% increase in the usage of the therapy as the first line of treatment.
Summary: Digital workflows now allow for the ongoing support of clinicians at the point of
care, using a combination of well-designed technical solutions and clinical logic that’s based
on patient data and the application of guidelines and drug labels.
Dr. Ronald Razmi
Ronald M. Razmi, MD, MBA began his career as a Cardiologist and as a McKinsey consultant worked with the world’s top life sciences companies in strategy, digital health, and product roadmap. He was CEO of Acupera, a digital health company focused on using analytics and digital workflows in improving chronic care management. He advises healthcare companies in a range of areas including commercial strategy, digital health, and Artificial Intelligence.
Dr. Gerasimos Petratos
Gerry Petratos, MD, MS, is CEO of Hiteks Solutions and began his career as an NIH-trained Medical Informatics physician with experience in EHR-integrated decision support systems from Intermountain and the University of Utah. Dr. Petratos has 9 years of experience as the former Global Head of Healthcare Data Analytics at Roche and Genentech.
Hiteks is proud to support the directors of a NYC-produced documentary film called The Candidates, which was shown in November at the DOCNYC film festival and at last week’s Big Sky Film Festival in Montana:
This high school in Queens serves as an example of how youth activities, including political ones, can be presented in an educational way and create engagement and knowledge generation amongst students. The film has already received distinction by entertaining offers from studios that will soon make the film available to audiences via streaming. If you are interested in screening this film at a local high school please let us know so that we can connect you with the directors.
The need for pediatrics-based education and focus is also paramount to health care, where knowledge can be shared of how to properly identify and manage children’s illnesses such as cancer, lung disease, infections, and many others. For instance, when these illnesses worsen they become the primary drivers of patients suffering from Sepsis and Status Asthmaticus and deterioration of outcomes seen when patients enter the hospital.
By sponsoring the directors of The Candidates, Hiteks is both fostering community awareness of political issues, as well as the co-morbid conditions which need to be captured for CDI (Clinical Documentation Improvement) and CDS (Clinical Decision Support) to improve care. Hiteks’ approach of optimizing the EHR for clinical decision-making can be best seen through our Pediatrics CDI, VigilantQA Sepsis Surveillance and CarePaths For Heart Failure programs. We are able to reduce false positive Epic BPA alerts for Sepsis and optimize advice for CDI from evidence-based guidelines through our engineering which accommodates patient age and demographics, along with client-specific logic.
We will be using the funds from our investment in this film for the continued research and development of pediatrics programs in CDI and CDS for sepsis surveillance programs. If you are interested in how your local hospital or health system can better monitor for these conditions to improve CDI, patient safety and outcomes, please contact us.
New York, NY, October 24, 2018 – Hiteks Solutions Inc. announced today that they have upgraded their Sepsis detection, monitoring and management solution currently in operation at over 28 U.S. hospitals nationally, with the ability to reduce the false positive alerts within Epic. While the solution, VigilantQA – Sepsis Surveillance, has been running since 2016 by obtaining EHR data through real-time interfaces with MEDITECH and Epic, the upgrade now allows BPA alerts within Epic to be fully automated to accurately reflect Early Sepsis, Sepsis, Severe Sepsis and Septic Shock conditions according to the latest CMS, MEWS and Surviving Sepsis Campaign criteria.
VigilantQA – Sepsis Surveillance improves the positive predictive value of alerts by reducing false positives through identification of comorbidity, infection source and organ system dysfunction confounders which are known to cause alert fatigue.As a result, higher usability and confidence in the alerts also increases the timely identification of sepsis and infection sources within the 3 and 6-hour windows. Alerts can be directed to performance improvement specialists, charge nurses, other nursing staff, hospitalists and/or other clinicians. VigilantQA – Sepsis Surveillance also includes a real-time abstraction for reporting module to reduce the time and resources required in the CMS reporting processes.
EHR workflow benefits by integrating the Sepsis alerts with the Patient List Screen of care providers as a separate column, and optionally sending positive cases along with the “Evidence” and “Next Steps in Management” to specific users.Also, the triggers of the alerting can take place at various points in the clinical workflow such as Signing Orders and Opening Patient Charts, amongst others.The alerting algorithm can be configured differently based on adult and pediatric patient type and hospital setting such as ICU, NICU, PICU, Emergency Department, Post-Op, or the floor based on Hiteks’ A.I. which monitors hundreds of data points to determine the most likely causes of false positives and false negatives.
Hiteks’ current and prospective clients are eligible to receive this upgrade with Epic version 2018 through Epic’s App Orchard: https://apporchard.epic.com/Gallery?id=271 or through Hiteks’ website: www.hiteks.com/VigilantQA.Due to the high demand for this application and the new upgrade, Hiteks is able to offer significantly reduced pricing for new clients and multi-year contracts.Hiteks also offers a no-risk free trial for 6 months with no commitment to buy.
About Hiteks
Hiteks is a leading provider of hosted and EHR-integrated Decision Support software solutions to enhance physician time and knowledge by enabling real-time feedback to clinicians at the point of care with tens of thousands of clinicians nationally using its cloud software.Hiteks’ software reviews all the relevant discrete and Note data to automatically provide feedback to the clinician in the EHR in less than one second. For more information, please visitwww.hiteks.com, or https://apporchard.epic.com.
Contact Information: Dave Thomas, Hiteks Solutions, Inc., (212) 920-0929,dave@hiteks.com
New York, NY, September 6, 2018 – Hiteks Solutions Inc. announced today that they have upgraded their Artificial Intelligence (A.I.) and Sub Second Natural Language Processing (NLP) solutions to incorporate Clinical Decision Support (CDS) triggers which allow for clinical documentation improvement (CDI) to be delivered not only within the note writing and review process for physicians but also at key “trigger” points in the clinical workflow such as Signing Orders and Opening Patient Charts. The new CDS triggers in the clinical workflow ensure that important reimbursement and quality-related findings do not get missed. More importantly, physician time spent reviewing CDI queries and quality alerts is reduced due to the reduction of back and forth navigation within the patient chart. CDI and HIM queries can otherwise consume excessive time and result in low compliance amongst physicians. All current Hiteks clients are eligible to receive this upgrade at no charge within their Production Epic EHR system to take advantage of this cutting-edge capability.
Hiteks’ Insight Real-time IntelligenceTM suite of tools is engineered to support real-time computer-assisted physician documentation (CAPD) through the processing of clinical data with automated alerts and queries to physicians. The first-generation software architecture produced in 2013 targeted CDI and Quality suggestions to the physician in areas such as Sepsis, Heart Failure, Pneumonia, Kidney Failure, and a host of other inpatient and ambulatory Pediatric and Emergency conditions. The new upgrade is the second-generation improvement not offered by competitors and incorporates the full integration with Epic’s CDS Hooks and BPA Framework to leverage the additional workflow triggers. Now physicians can receive the alerts both within the NoteReader CDI module (which is during the note writing and review workflow), as well as the CDS/BPA modules which allow the suggestions to be delivered when physicians sign orders and open the patient chart.
With the latest CDS upgrade, users will be able to apply additional CDI logic in inpatient, ambulatory, pediatric and emergency department settings where the need to target physicians comes in different points of the workflow. For example, whenever the order for an imaging procedure or medication is not supported by a clinical diagnosis in the note or diagnosis list, an alert will fire when the physician goes to sign her orders to inform the physician of the need for an updated diagnosis, and also offer the relevant evidence of the discovered documentation deficiency. In another instance, a physician will open up a chart which has been determined to require additional attention due to newly received diagnostic test results for Sepsis, and if there is a mismatch between the physician’s stated diagnosis (e.g. Severe Sepsis) and the computerized diagnosis (Septic Shock), then the labs/meds/vitals and organ system dysfunction evidence will be shown for confirmation of the diagnosis. Other solutions only apply their CDI to the Notes and fail to reach the physician at these important additional clinical workflow data entry points where this added clinical decision support efficiency greatly benefits quality initiatives and revenue cycle management.
Hiteks’ Insight suite of software solutions embedded within Epic includes AdvocateMD Powering NoteReader for improved “Front-End” Physician CDI Specificity through better Problem List Management and Automated Epic Diagnosis Calculator. Hiteks also provides VigilantQA Sepsis Surveillance to reduce the time to identify Sepsis, Severe Sepsis and Septic Shock cases, and ConcurDI For NoteReader CDI for “state of the art” CAPD featuring Real-Time Automated CDI Queries. The latest CDS upgrade allows for all of these tools to function as a coherent unit and offers the most flexibility for the physician to leverage Hiteks’ configurable CDI and Quality query library with the greatest out-of-the-box queries and ability to quickly create new ones compared to competitors.
Hiteks is a leading provider of hosted EHR-integrated Real-Time Decision Support software solutions. These Hiteks work flow solutions reduce the time a physician has to spend in the EHR while providing physicians instantaneous specificity clarifications through real-time feedback at the point of care for improved “Front-End” Physician CDI. Tens of thousands of clinicians nationally are using Hiteks hosted cloud services. Hiteks’ software reviews all the relevant discrete and Note data to automatically provide feedback to the clinician in the EHR in less than one second. For more information, please visit www.hiteks.com or https://apporchard.epic.com.
New York, NY, August 8, 2018 – Hiteks Solutions Inc. and University Medical Center of Nevada (UMC) today announced that they have reached an agreement to implement ConcurDI For NoteReader CDI in their Production Epic EHR system this summer with an accelerated implementation timeline. In addition, UMC will be using Hiteks’ AdvocateMD Powering NoteReader for automated Diagnosis Calculator and Problem List Management, as well as Hiteks’ VigilantQA Sepsis Surveillance to reduce the time to identify Sepsis, Severe Sepsis and Septic Shock cases.
UMC will become the 20th hospital to receive Hiteks’ newest solution integrated with Epic: ConcurDI For NoteReader CDI, part of Epic’s App Orchard marketplace. UMC follows Rush University Medical Center and other academic and community hospitals who use Epic. UMC selected Hiteks’ Computer-Assisted Physician Documentation (CAPD) service, which includes proprietary Search, A.I. and sub-second Natural Language Processing (NLP) technology due to its speed, configurability and its clinical guidelines-directed management knowledge. Hiteks is the only true real-time CAPD solution in the industry, where “real-time” is defined is processing data within milliseconds so that it is available virtually immediately as feedback to physicians. When compared to the legacy systems of its voice recognition, CDI and coding competitors, Hiteks avoids hard-coding and rigid software architectures which make EHR integration and clinical workflow customization challenging and expensive. Hiteks’ extensive query library of clinical subject areas (e.g. pneumonia, malnutrition, obesity, heart failure, acute asthma, pediatric suicide ideation, pediatric burns, snake bites, acute neuropathy, NICU respiratory, NICU hypoglycemia) also contributed to UMC’s decision to work with Hiteks since their pre-packaged queries have been tested with other clients and can be supplemented by UMC-specific additions or variations in a matter of minutes.
The goal in using Hiteks’ Insight Real-time IntelligenceTM suite of tools is to provide physicians with automated support that reduces the time it takes to access relevant clinical data so that they can make the best decisions for their patients. Physician decision-support and workflow has been an important issue with the digitization of records because, although information is centralized into EHR systems, getting good data into and out of the systems for patient care has been a challenge. Since Hiteks is owned and managed by doctors who have been in clinical practice, they understand that real-time computerized support can enhance quality care and reduce the annoyance of computers. Hiteks applies its technology and clinical know-how by designing feedback at the time of note-writing so providers can document accurately according to national guidelines and speedily interpret complex clinical information composed of medical problems combined with diagnostic test results, medications and vital signs.
Doctors who use Hiteks integrated with their EHR get valuable feedback on both implicit and explicitly-stated diagnoses which require attention due to either documentation integrity issues or quality concerns from worsening patient conditions. Doctors who use Hiteks are able to respond in a timely manner which results in higher compliance compared to manually generated CDI queries or guidelines references. Physician time is saved by avoiding the retrospective EHR navigation to re-open patient charts when CDI or Quality suggestions come in after-the-fact. From a financial perspective, the timely feedback improves capture of data and documentation which reduces the revenue cycle time to submit claims and supports severity-adjusted quality scoring, accurate coding and reduces denials. Since Hiteks uses modern modular software architecture it can price its solutions significantly less than competition and help its clients reach a greater ROI.
Further differentiation by Hiteks’ service includes guidelines-directed management of conditions such as heart failure and sepsis to support physicians with timely patient-specific reference information which promotes high quality care. Automating documentation practices based on the knowledge of CDI, Quality and HIM staff as well as peer-reviewed guidelines references allows Hiteks to optimize throughput of documentation improvement and quality advice with evidence-based approaches. Hiteks is the only vendor integrated with the EHR to allow for customer-specific evidence and documentation suggestions as well as tapping into its evidence base of computerized guidelines.
According to Gerry Petratos, MD and CEO of Hiteks: There exists a great opportunity with UMC for us to support their multi-specialty environment, including Pediatrics, Surgery, ICU and Emergency Departments with real-time physician feedback. UMC will benefit from our previous implementations where we have learned from other clients and tested new logic to enhance accuracy and grow our Query and Guidelines Library. I expect that UMC will use 80% pre-packaged queries from our Library and 20% customized queries. At the same time, we will learn from UMC’s clinical workflows and patient mix to continuously improve our NLP, A.I. and computerized guidelines with the real-time feedback we receive from UMC physicians. UMC is also participating in a national incentive for 2018 to increase adoption of our Epic-integrated tools with discounts allowing them to benefit financially immediately upon implementation of our tools.
UMC is an academic medical center in Southern Nevada and serves as the anchor hospital of the Las Vegas Medical District, offering Nevada’s highest level of care to promote successful medical outcomes for patients. UMC provides patients with access to a wide range of exclusive and specialized services, including Nevada’s only Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center and Center for Transplantation. UMC also has a strategic partnership with the UNLV School of Medicine, serving as the anchor partner for the newly developed school to deliver the region’s finest academic medicine.
Hiteks is a leading provider of hosted EHR integrated Search, A.I. and NLP software solutions to enhance decision support by enabling real-time feedback to clinicians at the point of care with thousands of clinicians nationally using its cloud software. Hiteks’ software reviews all the relevant discrete and Note data automatically and provides accurate feedback to the EHR in less than one second in a configurable environment. For more information, please visit www.hiteks.com, or https://apporchard.epic.com.
New York, NY, May 29, 2018 – Hiteks Solutions Inc. and Rush University Medical Center today announced that they have implemented ConcurDI For NoteReader CDI in Rush’s production Epic environment across their hospitals. Hiteks collaborated with Rush in 2017 with the implementation of Hiteks’ AdvocateMD Powering NoteReader to prove that they could speed the delivery of Clinical Documentation Improvement (CDI) and Quality queries directly to physicians in an automated approach that doesn’t slow doctors’ workflow and enhances efficiency of CDI and Quality functions by providing real-time, configurable queries to prioritize charts for reimbursement and quality review.
With the power of NoteReader CDI, physicians can get feedback on diagnoses which require greater documentation or on a combination of signs, symptoms, lab results, medications and vital signs which may indicate a condition that has not been mentioned by the physician. The additional timely physician feedback improves severity-adjusted quality scores, claims codes and reduces denials to improve overall care management.
In June 2017 Hiteks joined Epic’s App Orchard to provide more access to its Insight platform for physician decision support and analytics tools that can be accessed by any of Epic’s clients. Rush selected Hiteks’ Computer-Assisted Physician Documentation (CAPD) service, which includes a proprietary Search, A.I. and sub-second NLP technology that is real-time, configurable and well supported, due to its level of integration with Epic.
According to Shafiq Rab, MD, MPH, FCHIME, CIO and Senior Vice President at Rush University Medical Center, “Hiteks is able to streamline our physician workflows so that all the information required to better understand the patient’s condition as it relates to quality and CDI queries is available within 1 screen and immediately after a draft or finalized note is created. Hiteks’ participation in the App Orchard Program allows us to benefit from the work that Hiteks has done to reduce complexity of interfaces and promote further interoperability between systems so that the net benefit is derived from our physician users and patients under our care. Furthermore, we have implemented this system to ensure efficiency, not staff replacement, with the automated rules defined and controlled through configuration by our CDI and Quality experts.”
Focus on High Impact Alerts for Quality To Improve Patient Care
By enabling speedy queries with fewer false positives Hiteks and its clients have measured over 50% reduction in overall queries compared to a process involving only manually issued queries. Hiteks provides a fast and accurate analysis of the patient’s chart in milliseconds to provide immediate feedback to documenting providers. Hiteks’ proprietary Search and non-legacy technology are architected in a way that enables it to be configured for new clinical terms, note types, negation and section headings quickly and easily. In addition, Hiteks focuses its solutions on detecting incomplete documentation from a quality standpoint, ensuring that both quality care (i.e. Sepsis Surveillance) can be improved, along with revenues. Hiteks supports a fully compliant and customizable query configuration environment specific to the needs of each individual customer which bypasses typical software code change required by legacy systems.
According to Gerry Petratos, MD and CEO of Hiteks: “Working with Epic’s Development Teams and its CDI and clinical users, we have helped hospital systems achieve a high compliance with Quality and CDI related suggestions on the front-end to speed physician access to computerized suggestions. These suggestions are based on query logic controlled by the CDI and Quality staff’s expertise, and delivered through Hiteks’ modern software approach, without forcing a uniform set of rules or query language onto an organization. All physician specialties are included, including Pediatrics, OBGYN, Surgery, Emergency, as well as quality areas like Sepsis, and prioritized diagnoses like Pneumonia, Acute Renal Failure, Acute Respiratory Failure, Pediatric Asthma, Malnutrition and Obesity. Others are prioritized based on our agreement with the CDI/HIM and Quality staff to either go straight to the documenting physician without disrupting the physician workflow, or in silent mode go to the CDI staff first to review. Finally, the information that Hiteks returns to the physician and the physician responses can be tracked to measure the CDI and coding impact, usage statistics and workflow metrics. We plan to implement ConcurDI For NoteReader CDI at an additional 13 hospitals in June along with ambulatory settings over the summer, followed by a steady growth of users for the rest of 2018.”
About Rush University Medical Center
Rush is an academic health system whose mission is to improve the health of the patients and the diverse communities it serves with nationally recognized health care, education, research and a commitment to community partnerships. The Rush system comprises Rush University Medical Center, Rush University, Rush Copley Medical Center and Rush Oak Park Hospital, as well as numerous outpatient care facilities. Rush University, with more than 2,500 students, is a health sciences university that comprises Rush Medical College, the College of Nursing, the College of Health Sciences and the Graduate College.
About Hiteks
Hiteks is a leading provider of hosted EHR integrated Search, A.I. and NLP software solutions to enhance decision support by enabling real-time feedback to clinicians at the point of care. Hiteks’ software reviews all the relevant structured and textual data automatically and provides accurate feedback to the EHR in less than one second in a configurable environment. For more information, please visit www.hiteks.com.
Contact Information: Dave Thomas, Hiteks Solutions, Inc., (212) 920-0929, dave@hiteks.com
While the impact of Medical Scribes on physician workflow and documentation has been well documented with several articles over the past few years (see below links), the impact of A.I. and CAPD is just now being realized and measured.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598196/pdf/ceor-7-489.pdf
https://www.beckershospitalreview.com/patient-flow/are-medical-scribes-worth-the-investment.html
Since A.I. and CAPD (Computer Assisted Physician Documentation) are the latest technology enhancements to physician workflow, Hiteks has embarked to measure the impact in a controlled study of its Insight: Real-time Revenue Rescue platform on workflow and documentation. This 2018 study is being organized which includes the following considerations, including access to Hiteks’ A.I. and CAPD software tools AdvocateMD and ConcurDI powering Epic NoteReader and NoteReader CDI, respectively, at no charge during the course of this study:
Inclusion Criteria: Institutions using Epic versions 2015 or 2017 and who have employed Medical Scribes as part of their workforce for at least 12 months
Study methods: Measuring the before-and-after impact of using Hiteks powering Epic’s NoteReader and/or NoteReader CDI software tools in these 4 areas:
Since 2014, Hiteks Solutions Insight: Real-time Revenue Rescue software has been providing physicians advanced real -time Clinical Decision Support inside the Epic EHR.
You could think of this study is a little like… John Henry vs. the Steam Powered Hammer.
For more information, please contact info@hiteks.com or call us at 212.920.0929.
Hiteks Solutions Inc. is a clinical documentation improvement (CDI) software company based in New York City. We focus on highly accurate Artificial Intelligence (A.I.) sub-second clinical natural language processing (NLP) inside the EHR. Our Insight™ solutions are currently the fastest, most accurate and widely adopted A.I. / NLP solutions to be integrated with EHR systems. Our vision, speed, accuracy, configurability, security, proprietary knowledge bases & support have allowed us to connect with healthcare providers throughout the country. We have over 100 hospitals and large medical practices as clients in over 15 states. Here’s why so many healthcare facilities are choosing Hiteks’ ConcurDI, which powers Epic NoteReader CDI in Epic version 2017:
Instead of having to rely on untimely and incomplete knowledge from back-office staff who perform manual reviews, physicians now have all reimbursement information at their fingertips as soon as they complete their notes. This includes the following up-to-date insurance-specific information, which is based on Hiteks’ experience and proprietary reference knowledge of millions of rules:
10x faster than any other NoteReader CDI solution currently on the market, Hiteks’ ConcurDI has a 2-second average response time (1 second Hiteks response + 1 second added for network latency). Competitors’ system response times are typically over 10 seconds and support only “silent mode” because they are not accurate enough for real-time, often causing providers to move onto their next patient without responding to the CDI clarification. With our CDI solution, providers will never have that problem.
Providers can simply click and the documentation process will be complete. We have tested and continuously improved the knowledge base associated with the algorithms that are finding the evidence in support of a CDI query.
Hiteks’ ConcurDI utilizes Coding Rule Specificity and has built in medical necessity knowledge, which identifies incomplete clinical terms and suggests possible specificity modifiers during documentation. It also identifies areas that lack appropriate justification for a reimbursable diagnosis or procedure. This leads to fewer false positives and false negatives, as well as less alert fatigue and 30-50% fewer pending queries to answer.
Hiteks is the only vendor to offer a CDI solution with execution in Synchronous and Asynchronous modes.
– Synchronous: Provides immediate (<2 seconds) response time to physicians who are in the process of completing a note. This enhances claims coding capacity and compliance while reducing time spent on revenue cycle. Synchronous in NoteReader CDI allows providers to significantly reduce the amount of time spent on returning to their patient’s chart to manually review CDI Queries.
– Asynchronous: Provides validation of queries for CDI/HIM/Quality in “Silent Mode” which is especially useful for testing and refining real-time Synchronous logic.
This ensures the protection of all patient health information (PHI). Unlike legacy vendors who use Microsoft platforms, Hiteks leverages more secure Linux systems.
Hiteks’ User Customization Menu allows Hiteks users to add their own local terms or abbreviations for their clinical specialization by searching through SNOMED terminology in the Terms section. ConcurDI is deployed as a service API for CDI Designer, which allows client personalization through custom GUI configuration without having to use Epic “Silent Mode”. Hiteks also has a default configuration that can be used out-of-the-box.
Clients can expect a guaranteed return on investment (ROI), as we use clinical benchmarking, metrics and analytics to constantly improve our clients’ operational and financial performance.