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Health Information Exchange Enhances Decision Making

The Wisconsin Health Information Exchange gives emergency room doctors access to patient data faster, helping improve clinical decisions and identify waste, drug abuse, and misuse of ER services.

A study by the Medical College of Wisconsin finds that emergency room doctors who have electronic access to patient data via a health information exchange spend less time gathering information and make better-informed clinical decisions in treating patients.

The study surveyed emergency room doctors about 185 patient encounters in three sites involved with the initial launch of the Wisconsin Health Information Exchange, which has been in operation for about three years in Milwaukee County and is currently being used in 10 emergency departments and several outpatient care facilities.

Doctors using the WHIE reported that electronic access to patient data reduced the time they spent gathering pertinent information about patients and helped the doctors gain a more comprehensive perspective on patients, enabling faster and better informed treatment decisions.

Sources contributing data to the WHIE include 42 area hospitals, all which provide data for public health department surveillance. Twenty-two of the participating hospitals belong to five integrated delivery networks that are sharing patient clinical data to the exchange in addition to public health related data.

Other sources providing data to the exchange include Wisconsin state Medicaid, which is contributing claims, pharmacy, and patient encounter information. Also sharing data are several health clinics and a federally qualified health clinic in southeastern Wisconsin.

The health information exchange uses Microsoft's Amalga unified intelligence system to aggregate data from the multiple sources and provides doctors at the point of care with a unified view of patient medical history data.

It's this electronic view of patient data, which includes information such as lab procedures, prescribed medications, and patients' chief complaints, previous visits, and treatments, that helps emergency room doctors reduce the time it takes to gather information and make decisions for safer and appropriate care, said Kim Pemble, executive director of the WHIE.

"Doctors are telling us the exchange is important in treating patients," he said. Not only does the point-of-care access help reduce the time spent in emergency rooms collecting information about patients, but also helps doctors avoid ordering redundant or unnecessary tests, or prescribing medications that could cause adverse reactions in some patients, such as those with allergies or taking other drugs.

Dr. John Whitcomb, an emergency department doctor at Aurora Sinai Hospital in Milwaukee, said that the use of the health exchange goes further than that.

Whitcomb said use of exchange information is helping the hospital identify patients who overuse or misuse the emergency room for medical issues that can be better and more affordably addressed in other care venues, such as by a primary care physician.

"With the health exchange, I can see right away how many times a patient has been to an ER in the region," he said.

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