Evolving accountable care organizations will need to coordinate care, measure quality, and implement the tools needed to manage wellness. All these goals require novel IT infrastructure and applications.
I've prepared a roadmap which illustrates how every EHR and Hospital Information System among all our affiliated partners exchanges (or will soon exchange data). Yesterday, an important part of that strategy, bidirectional data exchange between BIDMC's systems and Atrius Epic System went live.
Since January 2010, all Atrius Epic clinical users have been able to view BIDMC data about the patients we share in common.
Since March 31, 2011, all BIDMC clinical users have been able to view Epic data about the patients we share in common.
A link called Atrius Epic Web appears on the BIDMC Patient Profile screen when a patient is shared between Atrius and BIDMC. The link displays automatically if the patient has a primary care provider who is affiliated with Atrius.
When a BIDMC clinical user wants to access Epic Records, they click on the link. and a comprehensive web-based summary of the patient's Epic records (the graphic above) appears, without requiring a new login or re-specifying the patient. The patient lookup is captured in the audit logs of both BIDMC and Atrius.
The entire exchange is done using simple secure RESTful calls between web servers at BIDMC and Atrius.
Comprehensive bidirectional data sharing in support of patient care among independent organizations. That's cool.
It would be interesting to hear how and when you correlate patients with this approach. Also can all clinicians from one organization see all the intersecting patients from another organization?
ReplyDeleteIt's name, gender, date of birth match between our two registration systems. Not perfect, but 95% match rates with no false positives is good enough.
ReplyDeleteI was wondering how this is related to the SHARP/SMART Challenge, as this looks pretty like an implementation of SMART. It also uses a REST interface to exchange the information.
ReplyDeleteAnother question: if this works so well, do we need still (HL7) messaging between applications ?
John, interesting project. In looking at the screenshot of Atrius Epic, I noticed that several of the problems and meds are redundant. Any particular reason why? I can imagine it would get cumbersome to use if these things were repeated inappropriate for a complex patient over a long period of time. Also, do you have any experience with what McKesson is doing along these lines? Their Horizon Physician Portal for years has been a single signon tool with interfaces built in context into disparate systems for information sharing. They're currently very close to taking that a step further and actually incorporating discrete data into the EMR, having already done it in a pilot project with GE. Now that would be really cool if they can pull that off.
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