Archive for November, 2017

An Overview of McKesson and Paragon

Posted by Ashley McCool on November 16, 2017 in Blog, News

A Brief History of McKesson

Originally founded in 1828 in New York City as Olcott by Charles M. Olcott, and later known as Olcott, McKesson & Co. by Charles Olcott and John McKesson in 1833, the business began as an importer and wholesaler of botanical drugs. Years later, a third partner, Daniel Robbins joined the enterprise as it grew, and it was renamed McKesson & Robbins following Olcott’s death in 1853.

During the mid-20th century, the company transitioned from mainly a pharmaceutical company to a medical technology company. In 1999, McKesson & Robbins acquired a medical information systems firm, HBO & Company and was briefly known as McKessonHBOC. In 2010, McKesson acquired leading cancer services company US Oncology, Inc. for $2.16 billion, which was integrated into the McKesson Specialty Care Solutions business. In addition to its offices throughout North America, McKesson also has international offices in Australia, Ireland, France, the Netherlands, and the United Kingdom. Today, McKesson is one of the oldest continually operating businesses in the United States. As of August 2016, McKesson merged a majority of its IT business with Change Healthcare. McKesson is currently headquartered in San Francisco, California, with 190.8 billion revenue (2016) and 68,000 employees (2016).


About McKesson

McKesson delivers a comprehensive offering of healthcare products, technology, equipment and related services to the healthcare industry and non-hospital market — including physician offices, surgery centers, long-term care facilities and home healthcare businesses — throughout North America and internationally.

McKesson supports pharmacies by expanding the range of medical supplies and services they offer customers. In addition, they work with pharmaceutical manufacturers, as well as practice management, technology and clinical support to oncology and other specialty practices, to help develop and deliver advanced medical treatments that lead to improved care and outcomes. McKesson also provides pharmaceutical distribution services that are customizable and scalable for hospitals and health systems of all types and sizes.


About the Software

Paragon – Inpatient EHR System

Paragon is a fully integrated clinical and financial system designed for hospitals and health systems of all sizes. McKesson highlights these benefits and advantages to using the Paragon system:

  • Helps reduce system complexity and lowered cost of ownership: Designed around a technology platform that helps reduce system operational complexity via a fully integrated clinical and financial system, a modern, non-proprietary operating platform and a Microsoft® SQL server platform. In addition, by using the Microsoft® SQL technology and architecture throughout, Paragon simplifies data management through the normalization and familiarity of the Microsoft® platform.
  • Easy-to-use, comprehensive software applications: Paragon offers a broad suite of clinical and financial applications with anytime, anywhere access via the web.
  • Single vendor for all clinical and financial needs: Partnering with a single vendor for all clinical and financial operations helps navigate the health care landscape while efficiently maximizing the clinical and financial performance of the organization.


Paragon user-friendly applications for clinicians include:

  • Clinician Hub: Web-based information presentation and workflow management solution that allows clinicians to view clinical and administrative information, document care, and place orders for patients
  • Computerized Physician Order Entry (CPOE): Integrated, physician-friendly solution providing direct order management and clinical decision support
  • Clinician Mobile: Provides clinicians with fast, efficient and secure mobile access to patient-specific clinical information
  • Physician Documentation: Integrated solution that supports care communication and charge capture via the physician’s natural workflow
  • Medication Reconciliation: Integrated solution to review medications, communicate changes and place orders
  • Clinical Assessment: Enables caregivers to collect and evaluate patient assessments, vitals and I&O as well as automating flow sheets and therapy assessments
  • Care Plans: Automates the workflow for the patient care planning process and helps reduce the time required to create and document patient care interventions
  • Order Management: Facilitates order entry, charge capture, patient profile information and order interactions for all patient types
  • Medication Administration: Offers a point-of-care solution that helps support medication safety while systematically documenting the administration process
  • Clinical Data Interface: Helps increase efficiency of clinical staff and helps reduce errors by importing discrete physiologic data from third-party devices, such as bedside monitors or ventilators


Paragon applications to assist ancillary departments include:

  • Pharmacy Management: Combines patient demographic and clinical information with specific drug information to help manage drug therapy
  • Operating Room Management: Provides OR and resource scheduling, real-time perioperative charting at the point of care; helps users manage surgical supply inventory; captures charges and provides robust reporting
  • Emergency Department Information System: Provides Emergency Department documentation for physicians, nurses and mid-level providers, while also supplying tracking board, registration, triage and reporting capabilities
  • Inpatient Physical Rehabilitation: Allows users to utilize the CMS standard Patient Assessment Instrument in a clinical setting and for the calculation of RIC codes
  • Radiology Management: Enables hospitals to manage and report on all radiology procedures performed within their organizations
  • Laboratory Management: Helps manage workflow and automate test reporting and quality assurance information
  • Mobile Specimen Collection: Helps improve accuracy and productivity through the use of handheld barcode technology to identify patients and collect specimens at the bedside
  • Microbiology: Helps manage the specialized department workflow in a paperless environment


Paragon administration and hospital financial applications include:

Business Office and Administration

  • Patient Management: Offers a complete patient accounting application, including billing and collection that can interface with ambulatory EMRs and centralized collections
  • General Ledger: Provides inquiry, audit trails and automated entries to help organizations analyze current performance and project future trends
  • Accounts Payable: Provides management of multiple discount rates, minimum dollar order limits and payment cycles
  • Materials Management: Improves control over inventory management with tracking and comprehensive reporting
  • Payroll: Helps improve control over inventory management with tracking and comprehensive reporting
  • Patient Supply Charging: Helps reduce revenue loss from undocumented patient supplies and improve inventory management
  • Fixed Assets: Helps manage the organization’s physical plant and equipment and forecasts future depreciation assets
  • WebStation for Executives: Provides a personalized gateway and decision support tool to a broad array of enterprise-wide information
  • Automated Daily System Close: Enables unattended backup and nighttime operation

Patient Access

  • Referrals and Authorizations: Allows users to enter and track data regarding referrals for services and authorizations
  • Resource Scheduling: Allows users to better manage and control resources through coordinated scheduling of patients for clinics, procedures or exams
  • Registration: Provides access to patient admission, registration and discharge information across episodes of care

Health Information Management

  • Medical Records: Offers an intuitive, cost-effective process for maintaining and updating medical records
  • Medical Records Transcription: Automates the transcription process and decreases completion time
  • Utilization Review: Automates proactive inpatient case management from admission through discharge to help reduce loss from unpaid patient days
  • Release of Information: Helps the Health Information Management department track the release of patient health information data


The Paragon® Ambulatory Care Practice Management module includes:

  • Single registration screen across hospital, practice and clinic
  • Centralized billing across enterprise from one location in the system
  • Ability to schedule lab and radiology orders from a physician practice or clinic to a hospital
  • Single patient record for registering and billing patients
  • Enterprise scheduling across acute-care and ambulatory settings
  • Patient education
  • Health maintenance support

Paragon® Ambulatory Care Practice Management module helps organizations:

  • Reduce maintenance overhead managing disparate systems
  • Provide an improved user experience as module is built in Paragon, reduce potential user training time
  • Reduce the cost and hassle associated with paper/faxed lab and radiology results between the physician practice and the hospital
  • Improve physician and provider workflow
  • Save time by reducing the need to rekey data from the hospital or clinic

Paragon Clinician Mobile includes:

  • Patient Overview: vital signs, intake & output, results, orders, meds & IVs
  • Vital Signs: graphically and in table format
  • Intake & Output Summary: time periods of 24 hours, current shift and since admission
  • Results: critical and non-critical for laboratory, microbiology, diagnostic images, cardiology and more
  • Orders: details on patient orders grouped by active, on hold and recently ended
  • Meds & IVs: active and discontinued medications by STAT, routine, PRN and IV solutions
  • Patient Profile: demographic, longitudinal and care assignment information
  • Care Assignments: caregivers who are associated with a patient visit


In August 2017, Allscripts announced plans to buy McKesson’s EHR, revenue cycle tools for $185 million. Allscripts said that it will keep McKesson’s Paragon EHR for small hospitals and use its own Sunrise for larger systems. For $185 million, Allscripts gained the product portfolio which McKesson calls Enterprise Information Solutions, consisting of the Paragon EHR, Star, and HealthQuest revenue cycle technologies, OneContent content management tools, as well as Lab Analytics and Blood Bank.

Source and additional information:

What is Epic? A Quick Overview of Modalities

Posted by Ashley McCool on November 9, 2017 in Blog, General, News

About Epic

Epic is an electronic health record system (EHR) and company that develops software to help people get well, stay well, and help future generations be healthier. Known as one of the leading EHR vendors in the US, Epic has over 190 million patients with a current electronic record in the system.

About the Company

In 1979, Judy Faulkner, founder and CEO, launched Epic Systems Corporation from her basement with a $70,000 bank loan secured against her home and the equity of a few loyal programming customers. The privately held software company is based in Verona, Wisconsin and has a nearly 1.8 billion revenue. Originally named Human Services Computing but rebranded as Epic Systems in 1983, the company currently has over 9,000 employees.

The headquarters is known for its imaginative campus; each section of the campus has a different theme, ranging from farming to castles to New York City’s Grand Central Station. The campus also features a treehouse for meetings. Not only does the Epic campus boast a unique design, they are also proud of their sustainability efforts, which include six wind turbines and 18 acres of solar panels, and utilizes underground geothermal pipes for heating and cooling the campus buildings.

About the Software

The purpose of Epic is to give patients the tools to lead a healthier life. With MyChart, patients have access to personal and family health information. They can message their doctors, attend e-visits, complete questionnaires, schedule appointments, and have more involvement in managing their health when and where it’s most convenience for them. While in the hospital, patients can stay in touch with their care team by using the MyChart tablet, which also can be used to personalize educational materials.


Epic’s software is most commonly used in:

  • Community hospitals
  • Academic medical centers
  • Children’s organizations
  • Retail clinics (such as CVS Health)
  • Multi-specialty groups
  • Integrated delivery networks
  • Rehab centers
  • Skilled nursing facilities
  • Hospice care facilities
  • Independent practices
  • Patient homes and “on-the-go” mobile version


Types of Modalities

Each care specialty has a dedicated modality tailored to its exact needs. The content in these modalities are guided by the experts in their field, where steering boards contribute content and guide development, meeting the real-world specialty needs. Here is a breakdown of the major modules that Epic has released, along with the clinical areas where they are used:

ASAP ER Module

ASAP is the Epic module that deals with managing ER visits. It has a component that tracks which rooms are occupied, displaying room and bed status on monitors that are mounted on the walls near the nursing stations.

EpicCare Ambulatory

EpicCare Ambulatory is one of the main and largest components of the Epic System. Primary Care and Specialty clinicians use the Ambulatory Module to document visits, place orders, send prescriptions, perform in-office procedures, review results, and send communications to patients.

Epic Beacon Oncology

Beacon Oncology is the chemotherapy module in the Epic system. It is built around treatment plans for patients who are undergoing cancer treatment. Whereas most patient visits are either Outpatient or Inpatient, these visits are considered Series Visit Types, which span a longer amount of time.

Epic Beaker

Epic Beaker is the laboratory system for a hospital lab. Orders that are placed either in other parts of Epic or in an external system are transmitted to Beaker via an HL7 Interface1 for processing. When patients arrive to have their blood drawn, the results are entered into Beaker, which then get transmitted back to the ordering doctor.

Epic Bridges

Epic Bridges1 is the module for installing, configuring and maintaining clinical interfaces to other systems. See the reference below to learn more about interfaces.

Epic Cadence

Cadence is the Epic scheduling module for Outpatient and Specialty clinics. Any time you have an appointment with your doctor, their scheduling staff will use Cadence to book your appointment, then check you in on arrival. The physicians and other staff are able to see the schedule for the whole clinic, or just for their own patients.

Epic Caboodle – aka Cogito Data Warehouse

This area of Epic refers to the data warehouse and analytical tools used to store and retrieve large amounts of clinical data. The data can be queried to provide all manner of reporting to support care decisions, manage costs, and identify trends2. Other data can be brought in from non-Epic systems, and then used along with Epic data to provide reporting results. Until mid-2016, the trade name for these tools was Cogito, from the Latin phrase ergo sum: “I think, therefore I am”. In mid-2016, Epic renamed it to “Cabooble”, ie Kit & Caboodle. Get it?

Epic Care Everywhere

Care Everywhere is the network by which patient records are shared between different Healthcare organizations that use Epic. If you receive care at an Epic hospital in say, New York for example, then move to another state or even another country, your new care providers can run a Care Everywhere query from their instance of Epic to pull in your records from your previous providers. Care Everywhere operates as a Health Information Exchange.

Epic Cupid

Epic Cupid is the module for Cardiology practices. There are special clinical tools focused on cardiology care. Epic can also integrate or interface with external EKG devices to bring the EKG readings into the medical record.

Epic Happy Together

Happy Together is Epic’s effort toward communicating clinical information across different systems, including competing vendors. This is done from the provider standpoint by communicating through Health Information Exchanges. Also, many patients use Epic’s patient portal MyChart at more than one Epic location, such as a primary care office from one organization, and a specialist from another. Happy Together enables patients to see their clinical data from multiple locations in one MyChart session.

EpicCare Home Health

This is the module used in a home health setting, in which visiting caregivers (Nurse, Nurse Aides, PT, OT, etc) document care done in a patient’s home. Clinicians use a remotely installed software program that allows them to document in settings where they might not have any Internet connection. Then after they finish their work, they can reconnect to their organization’s network and perform a sync that uploads their documentation to the main Epic servers.

Epic Hyperspace

Epic Hyperspace is not a clinical module in itself, but rather the actual application client that is presented to users of most areas of Epic. When a nurse, doctor, therapist, or administrative staff launch Epic, the front-end software that is presented to them is called Hyperspace. It is typically installed on hosted servers that are accessed by many workstations throughout an enterprise, rather than being installed on individual users’ PCs. Citrix commonly used to host Hyperspace.

Since it is a core component of the Epic system, upgrades almost always include an update of Hyperspace. Epic Hyperspace is configured to display different menus, tasks, and options to users depending on their specific roles. For example, a pharmacist will be presented with many medication-related options, while a family practice physician will be presented with options to document clinical visits, place orders, and perform other clinically relevant tasks.

EpicCare Inpatient

EpicCare Inpatient is much like EpicCare Ambulatory, except that the clinical tasks are done in the hospital on admitted patients.

Epic Haiku

Epic Haiku is an App for Android and Apple that allows doctors to access a limited version of EpicCare Ambulatory. They can see and respond to test results, access their schedule, and see other clinical data on their patients.

Epic Healthy Planet

Healthy Planet is Epic’s Population Management system to help organizations deliver better care for a given population of patients. It is a direct outcome of the Affordable Healthcare Act, which established voluntary entities called Accountable Care Organizations. An ACO is set up to pay providers not just for delivering services, but for the healthy outcome of the patients who are enrolled in the ACO. Healthy Planet provides a suite of reports, dashboards, and workflow tools that allow Care Managers to manage patient populations in and apart from ACOs.

Epic Kaleidoscope

Epic Kaleidoscope is the Ophthalmology (Eye Care) module for Epic. It allows Ophthalmologists and Optometrists to perform eye exams, document eye related procedures, and write contact lens and eyeglass prescriptions.

EpicCare Link

When a hospital or other healthcare enterprise installs Epic, they typically interact with community physicians who do not have Epic, many of which do not have any electronic medical record system. EpicCare Link allows those providers to be given access to a web-based portal, allowing them to have limited use of the EMR to view activity on their patients who have received care at the associated hospital. It is usually configured to provide read-only access, meaning the external provider cannot place orders or do other clinical activity.

Epic Lucy

Lucy is not exactly a module, but is a concept of allowing patients to download and print their medical record in a usable format. This is called a Continuity of Care Document (CCD), and is considered a form of a personal health record.

Epic MyChart

MyChart is the web-based system that allows patients to manage their medical care in many ways. They can view test results, past and future visits, orders, medications, and more. They can also request appointments with physicians and ask non-urgent medical questions. A supporting App for Android and Apple is also available. Also, a newer feature that is beginning to emerge is the ability to conduct video visits with physicians. More about patient portals.

MyChart Bedside

Where MyChart is focused mainly on the outpatient and specialty parts of the patient record, MyChart bedside is intended for use while a patient is admitted to the hospital. It provides online tools for tracking your progress toward discharge, and can be configured to provide patient education material.

Epic OpTime

Epic OpTime is the Operating Room/ Surgery module for Epic. It has components for Inpatient Surgery as well as Outpatient Day Surgery.

Epic Prelude (ADT Patient Registration)

ADT stands for Admission, Discharge, Transfer. ADT is a critical part of the entire organization’s system because this is where the key information and status of all patients is managed. The Prelude module covers the hospital registration and insurance functions.


Radar is the dashboard configuration that is shared across almost all other Epic modules. Dashboards support reports, graphs, performance measures, helpful links, and much more pertaining to each area. For example, an OB dashboard will have measures relating to C-Section rates and number of births.

Epic Radiant

Epic Radiant is the Radiology module for Epic. It provides documentation, film tracking, and viewing of Radiology images.

Epic Sonnet

Epic Sonnet is a trimmed-down version of the main clinical application that is aimed at smaller organizations that cannot afford or don’t need the full-featured version. Epic will offer Sonnet to organizations as a software service hosted at their campus data center in Verona, WI.

Reporting Workbench

This is Epic’s application-side reporting solution which allows IT analysts to create and manage reports on date from most parts of the system. Users work from templates to get data on patient lists, orders, appointments, diagnoses, and much more. In Reporting Workbench, users do not run SQL queries to the database, as the tool is visually oriented.

Epic Rover

Epic Rover is the module that uses mobile devices to allow Inpatient nursing staff to do review and documentation tasks. Some of the functions that Rover helps with are chart review, medication administration, flowsheet documentation, and recording patient photos. It is not intended to take the place of Epic Hyperspace, the standard client for accessing clinical functions.

Epic Stork

Epic Stork is the Obstetrics module for managing pregnancy episodes on the Outpatient side, and documenting deliveries in the hospital.

Epic Welcome Kiosk

The Welcome Kiosk is about the size and shape of a small ATM, and allows patients to check in for appointments, pay co-pay amounts, sign documents, and print receipts and other materials.




Cyber Security Summary – October 2017

Posted by Ashley McCool on November 7, 2017 in Blog, News

The amount of healthcare breaches has decreased dramatically since September 2017. In the month of September, healthcare providers experienced 36 breaches with 464,722 individuals/records affected; yet in October, healthcare providers experienced 21 healthcare breaches with only 55,673 individuals/records affected. Contributing to these breaches in October were a few email, EMR, and paper/film breaches, and a hacking/IT incident.


Since the beginning to the year

Since the beginning of 2017, there have been 1,140 total data breaches causing over 171 million records to be compromised. Out of those, the healthcare industry accounted for 314 breaches and about 4.8M records compromised. The healthcare industry experience 27.5% of total breaches and 2.8% of records compromised.


Chase Brexton Health Care Notifies More Than 16,000 Patients After Phishing Incident

Between August 2, 2017, and August 3, 2017, a number of Chase Brexton employees received a bogus employee survey via email. It was determined that these email boxes did contain personal health information from several patients, including the following: patient name, patient ID number, date of birth, address, provider name, diagnosis codes, line of service, service location, visit description, insurance, and medication information.