Tuesday, March 12, 2013

Use of HIE Fully Integrated into the EHR

Note - while I was flying to Los Angeles to be with my father, I wrote the Tuesday-Thursday blog posts which will be automatically published this week.    I'm focused on his care now and will return to writing in real time once his needs have been met.

I recently reviewed an article which lamented the low adoption of portal-based HIE that requires clinicians to log into a website outside of their normal EHR workflow to lookup patient information from external facilities.  Typical usage in this article was cited as 10%.

At BIDMC we've implemented several types of interoperability that is integrated into standard EHR workflows at the click of the button - no additional login or patient context specification required.

How often is it used?   As an example, we looked at the lookups from BIDMC's EHR to the Atrius' Epic applications.  As denominator, we counted all adult admissions from 1/1/12 - 9/30/12 that had an Atrius PCP or referring MD.

There were a total of 6,017 Atrius admissions.

Of these, our audit logs show that 3,455 or 57% had an Atrius Epic viewer lookup used during the admission, between the admit and discharge date.

57% for simple integrated viewing verses 10% for community wide aggregation available via a separate website.

This was not intended to be an exhaustive or controlled study.  However, it is interesting that simple viewing of external records, fully integrated into the EHR, addresses many clinician requirements for care coordination.

I'm confident that the next generation of HIE such as the work of the Commonwealth of Massachusetts to create a statewide master patient index/record locator service and the nationwide CommonWell Alliance http://www.commonwellalliance.org by a consortium of vendors will empower additional fully EHR integrated solutions.

1 comment:

medicine for real said...

How did you get around the security concerns of interfacing two EHRs in two different systems? I understand each health system has their own rules about computer access and it sort of seems like you'd have to credential everyone in both places.