Madison, WI – May 5, 2010 - A patient normally seen at Group Health Cooperative makes an unplanned trip to the emergency department at St. Mary’s Hospital and cannot remember the medication they are taking. A UW Hospital emergency patient avoids having a second lab test for an infection because the same test had been done the day before and results were immediately available in the record. A Meriter emergency physician does not order a CT scan because he’s able to access the results of the scan done the day before at St. Mary’s Hospital.
In all of these cases, the patients were saved time, money or a potential medication interaction, thanks to a 120-day pilot project that area hospital emergency services and urgent cares are participating in. As part of this pilot, area providers now have electronic access to vital information from patients’ electronic medical records – when it’s needed most, no matter what hospital or urgent care they visit – provided patients choose to consent.
Dean Health System, Group Health Cooperative, Meriter Hospital, St. Mary’s Hospital and UW Health began testing the use of Epic’s Electronic Health Information Exchange module called Care Everywhere on March 29. Electronic health information exchange is for patients who have been seen by providers at other healthcare organizations that are using electronic medical record software that is capable of an electronic exchange.
Madison area providers all use the Epic Systems Corp. electronic medical record software so they have the benefit of using the same technical platform for this exchange, which streamlines and standardizes the electronic exchange process. Care Everywhere is in use in a few other communities across the country, including Minneapolis, and in limited locations in Colorado and California.
The pilot period allows electronic health record exchange within Dane County only and each organization will either elect to join the national Care Everywhere network or to discontinue use of the product at the end of the pilot phase. The pilot period is helpful in determining the value of health information exchange to Dane County patients as it relates to improvements in patient safety, quality and efficiencies such as reductions in cost due to the elimination of redundant tests and procedures.
“This takes advantage of the unique situation we have in Madison where everyone uses EpicCare for patient electronic medical records,” says Galen Metz, Chief Information Officer, Group Health Cooperative of South Central Wisconsin. “Madison is ahead of most communities in regards to electronic exchange and has achieved a level of cooperation and coordination among providers to ensure that all members of our community receive the best care possible by sharing important clinical information whenever and wherever a patient chooses to go for emergent or urgent care services.”
During the pilot Care Everywhere gives emergency services staff access to the patient’s medical records from the other participating organizations at the point of care. This functionality gives clinicians access to information that may be critical for patient treatment, but which they otherwise might not have easily obtained.
Patients need to sign a consent form to have their information electronically exchanged. The form is provided and explained to them at point of presentation in the ED or urgent care locations. Staff outside of the emergency services department with access to chart review have view-only access to information released during the Emergency Services contact through Care Everywhere.
Electronic access to medical records is similar to what is available when paper records are exchanged but greatly facilitates more timely and efficient access to relevant clinical information directly and immediately within the electronic record at the point of care. If a patient chooses not to consent to electronic health information exchange, care is provided based on patient provided information and/or paper records can be manually requested as they were before.
“Having the patient’s medical chart available when and where it’s needed is invaluable. It should cut down on duplication of tests, saving time and money. Prompt access to EMR increases efficiency and assists the physician’s ability to make safe, timely clinical decisions,” says Geoff Priest, MD, Meriter Chief Medical Officer.
Paper records can only be obtained when someone is staffing a medical records department. “Late nights and holidays, the value of Care Everywhere is most evident. Emergency Services physicians have access to clinic records that they otherwise would not have obtained until the morning or possibly the next day,” says Mark Kirschbaum, Senior Vice President, Quality and Information for UW Hospital and Clinics. UW Medical Foundation (physicians’ group) is also involved.
“Care Everywhere maximizes the major investment we are all making in technology with Epic being a major component to improved patient quality and safety. All of the major health care organizations involved in this project have been extremely generous in time they have given to this effort,” says Dave Lundal, V.P. & Regional CIO, SSM Integrated Health Technologies, SSM Health Care of Wisconsin.
Care Everywhere’s clinical summary provides an overview of the patient’s medical information including:
- Clinic and Hospital Visits
- Medical, Surgical, Family and Social History
- Lab results
- Medical imaging and EKG results
The summary does not include information considered sensitive such as alcohol or drug dependence or mental health encounters. It does include HIV diagnoses and test results.
Care Everywhere design includes security measures. Each time an organization sends or receives Care Everywhere information, an entry is added to the record and available for review. The audit trail entries are extensive including key elements such as the sending/requesting organization, requesting user, date and time of the request and the information sent and received.
“Care Everywhere insures that patients receive the best possible care no matter where they’re seen,” says Annette Fox, Director of Clinical Systems, Dean Health System and SSM Health Care of Wisconsin.