Suppose by some stretch of the imagination that every single U.S. hospital, medical practice, clinical lab, nursing home, and home health agency were interconnected and sharing patient data in real time.
No need to redo the ultrasound on Mrs. Smith because you can't locate the original one performed just last week at the hospital across town. No reason to worry whether she's allergic to the antibiotic she's about to receive because the medication history and allergy list from her last physician are now available via an EHR-to-EHR link. The list of advantages goes on and on.
Although the U.S. healthcare system is a long way from this kind of interoperability, several healthcare systems are moving in the right direction.
A case in point: Atrius Health, the largest multi-specialty medical practice in New England, has implemented an interoperability strategy that has generated a lot of positive feedback and participation from its physicians.
The group practice includes 1,075 physicians, 50 practice locations, and nearly 1 million patients, and it has strategic relationships with several area hospitals, including Beth Israel Deaconess Medical Center (BIDMC), Beverly Hospital, New England Baptist Hospital, Brigham and Women's Hospital, Newton-Wellesley Hospital, Faulkner Hospital, and Boston Children's Hospital.
[ To find out which medical apps doctors and patients are turning to, see 9 Mobile Health Apps Worth A Closer Look. ]
Atrius, which uses Epic for practice management and clinical record keeping, faced the challenge of sharing patient data with all of those independent hospitals. So it started what CIO Dan Moriarty refers to as a Web-portal-based interoperability project. The Atrius/BIDMC link was the first to go live, in January 2010.
In practical terms, what this means is that when an Atrius physician admits a patient for gallbladder surgery at BIDMC, for instance, he can open his Epic system and click a single button to take him directly into BIDMC's e-records on this patient--despite the fact that BIDMC doesn't use Epic's EHR.
As Moriarty explains: "Doctors don't have to open a Web browser. They don't have to log onto a VPN. There's no need to log on to each hospital's clinician portal." It's all automated and takes about two seconds to gain access to records that in the past would have taken much longer and required many more clicks.
What made this interoperability initiative workable was an integration utility--an API of sorts--that let Atrius link with each of its hospital partners. The underlying technology is SOAP-based Web services.
Moriarty is quick to point out that technology is only part of the success story. The fact that Atrius already established strategic relationships with these hospitals laid the groundwork for the kind of cooperation needed to implement each hospital/Atrius setup.
And of course, the Atrius "easy portal" isn't the only means by which the practice's physicians can gain access to patient data from other hospitals and practices. Massachusetts recently established a
But by any yardstick you care to use, the Atrius interoperability "magic" is still quite an achievement, one from which group practices nationwide can learn.
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