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Upgrade enhances e-health records for patient transitions

Dec. 11, 2014, 10:13 AM

People who study health care delivery tend to be interested in the ins and outs of patient information — how it’s gathered, how it’s used. One important focus is provider-to-provider communication associated with patient transitions between care settings.

Secure email hasn’t caught on for this communication; when hospitals and specialists send patient information to outside providers, they generally use a fax machine or regular mail.

Having worked for years to improve this communication, Vanderbilt University Medical Center has instituted a major upgrade.

As VUMC documentation is completed for a hospital discharge or clinic visit, when appropriate, Vanderbilt now transmits health records directly from its electronic health record system to outside EHR systems used by the patient’s other providers, and Vanderbilt’s EHR system also can receive records from outside providers by the same direct route.

For now, it’s not the entire record that’s transmitted; it’s instead a standard summary including patient problems, allergies, medications, immunizations, vital signs, diagnoses, care plans, procedures, lab test results, patient functional status, demographic information and referring provider contact information.

The EHR system also routinely pushes the summary to account holders on VUMC’s patient web portal, My Health at Vanderbilt, to allow patients to read and forward the information to outside providers as needed.

Key to this upgrade has been federal incentives specifying the electronic file protocol, the essentials of the summary and security requirements, including certification of HISPs (health information security providers), which are outfits that register providers and transmit files back and forth.

For community providers not registered with Vanderbilt’s HISP, communication of patient information continues to be by fax or mail.

“In a secure way, we’re opening the next new methodology of communication between health institutions. There’s still a lot of work to be done regarding how each side uses or consumes these documentations, but at least the pipes are now open to do this communication better than before. It’s essentially secure email, but with some standards of how documents are supposed to go back and forth,” said Neal Patel, M.D., MPH., professor of Clinical Pediatrics and Clinical Anesthesiology, associate professor of Biomedical Informatics and chief medical informatics officer at VUMC.

As the EHR-to-EHR upgrade went live, nothing changed for Vanderbilt providers in terms of documentation requirements. The upgrade builds on previous work at VUMC toward standardizing how patient information is collected.

As director of application development, Eric Boehme helped ensure that government requirements for this communication were met at VUMC.

“Before my dad died, he had so many different transitions of care, and getting that information was a challenge. Transition of care is a nightmare between different health systems. If we could get to the point where we’re routinely exchanging this data back and forth, it would be amazing.
“This is a start,” he said.

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