We see tremendous value in integrating ACP Decisions' video tools into clinical workflows in a seamless fashion. By working with clinicians that use our videos as part of their workflows, we can identify opportunities for reducing extra clicks, unnecessary typing, and laborious navigation. We are constantly on the lookout to understand better ways to integrate each video decision aid and other content into clinical workflows.
This document explores the potential value of an integration at your organization. It will evolve as our clients share more insights into their needs and objectives for integrating ACP Decisions' videos into their clinical workflows and EHR systems. We look forward to exploring integration objectives, simple models for integration, and possible integration points with you.
We look forward to your feedback to help us refine this document and identify additional opportunities for integration.
In our discussions with clients we have identified the following common clinical workflow objectives:
- Ordering videos;
- Verifying that patients viewed ordered content;
- Listing available videos;
- Redeeming patient codes within an organization's patient portal;
- Linking a code to a patient's EHR profile;
- Issuing a patient code from your system; and
- Merging utilization data from ACP Decisions with other reporting data
Clinical workflows involving the videos can vary from client to client and can change over time. Variations include ordering videos that are:
- Watched on an interactive TV system at the bedside;
- Watched via the My ACP Decisions website or ACP Tools mobile app (android/IOS);
- Shown by a navigator/nurse/aide/social worker/etc. as part of an ambulatory workflow; and
- Watched by patients and families at home using a simple code.
Some clients have created standard video orders through clinical intervention, disease or language.
We want to learn more about client-specific objectives and create general capabilities to support the broadest of client clinical workflow objectives. Please share your perspectives to help us provide a better platform for your important clinical work.
How does the My ACP Decisions system share content?
Healthcare professionals using My ACP Decisions can share content with patients using the following workflow:
- The clinician selects which resources they would like to order for the patient;
- Clinician confirms the order; and
- Clinician provides a redemption code to the patient and/or family member.
Why would I want to integrate with an EHR/EMR system?
Healthcare professionals want to know what content has been ordered for a patient and if that content has been viewed by the patient and the patient's loved ones.
My ACP Decisions allows for the sharing of content without collecting PHI. It tracks and manages utilization using an ordering system, where each order provides a unique identifier.
If integrated with an EHR these order numbers can be paired with an identifiable patient record to provide more context around who is using the codes and content.
What information does an order provide?
Each order provides the following information:
- List of redemption code(s), their purposes, and when they were last used;
- The list of content shared by the clinician; and
- A timeline of activity on how the content and codes are being used.
How is order information linked to an EHR?
For a patient record within a EMR system (EPIC, AllScripts, etc.), save a reference to the order number(s) for a patient. This might look something like this:
Patient Record (Provided by the EHR System)
- Order # 1234567890 (Complete)
- Order # 0987654321 (Started)
Periodically, the EHR could fetch order details using each order number.
What tasks does the API support?
- Listing resources available for ordering;
- Creating an order;
- Listing existing orders;
- Adding additional redemption codes to an existing order; and
- Redeeming a code and viewing its resources.
What do I need to integrate My ACP Decisions and an EHR such as EPIC or Allscripts?
In order to perform any of the API tasks listed above, the EHR will need to authenticate each request with a valid group login. Group logins are a username and password managed by a network administrator. All utilization is tracked on a per group basis, so it is important to setup group logins that reflect the clinical realities and administrative structure of the clinicians using the EHR and My ACP Decisions.
How group logins are organized is entirely up to the network administrators involved. Here are a few common examples:
- Regional Basis: Northeast, Northwest, Southeast, Southwest
- Per Hospital or Facility: Caring Memorial Hospital, Jacksonville Hospice
- By Team: Cardiology Consult Service, Palliative Outpatient Care, Case Management
How should I display the ACP Decisions library in my EHR?
How the ACP Decisions library is displayed is up to the network administrators involved, but we strongly recommend that the content in our growing library is organized in a way that makes it easily understood and discoverable.
The ACP Decisions video library has close to 300 videos for patients and families resources spanning 20 languages. Finding the right resource for a patient is extremely difficult if clinicians have to scroll through a list of this size.
ACP Decisions provides a few ways to segment our video library via the API. Resources can be grouped by language, category, disease, clinical setting, or collection.
What is the simplest way to display the library to users?
Collections provide a concise way for working with language versions (e.g English, Spanish, Arabic) and editions (e.g. Part 1, Part 2, Condensed, Extended) for a given concept. Most videos have a single video or document asset in multiple languages.
Collections group content into a logical hierarchy:
- Goals of Care: General Overview
- All Chapters
- All Chapters
- Dementia Taking Care Series
- Part 1
- Part 2
- Part 1
How would a technology team provide ordering and redemption code functionality from an EHR system (e.g. within EPIC or AllScripts)?
If you plan on providing a custom integration and would like to generate orders with redemption codes from your own EHR, you must do the following:
- Provide an interface to assemble an order of 1 or more resources within your EHR interface (e.g. shopping cart, drop down lists, or similar)
- Provide the ability for a user to submit resources to confirm an order (e.g "Confirm Order")
- Display the confirmation code returned from the API (e.g. confirmation screen, printed directions, or similar)
- Save a reference to the order to your EHR record for later reference (e.g. link order # 124567 for the patient record "Jane Doe")
Do you have an example of an integration?
Yes! We use our API in our own internal products. Our web, iOS, and Android apps all use API described above to deliver a "shopping cart" style workflow for building orders.
- Clinicians add the resources they would like to share which is displayed like a shopping cart;
- Clinicians then "check out" by confirming the order; and
- If confirmed successfully, a confirmation screen showing the order number and redemption code returned by the API along with any directions.
Depending on your internal workflows and the capabilities of your EHR system, you may take a different approach, but we have found this "shopping cart" workflow efficient and familiar.
Are there any limits when creating orders?
There is no limit on the number of orders you can create, but some resources are designed for providers. If you attempt to create an order with one of these resources, the confirmation will fail with an error message telling you which resource was in error.
To guard against this, each resource has information on whether or not it should be shared with patients.