January 3, 2008
Soon doctors and other clinicians at the University of Pittsburgh Medical Center's many hospitals and outpatient offices will be able to access key patient data, such as drug information, in a single view.
On Feb. 3, UPMC will begin to go live with the fruits of a multimillion-dollar interoperability project that's been more than a year in the making. UPMC in October 2006 signed a $35 million co-development pact and equity stake with Israeli-based dbMotion, a provider of service-oriented architecture-based middleware and software tools. That collaboration will soon enable UPMC doctors, nurses, and other clinicians to access a single view of patient data previously available only by tabbing through multiple screens and multiple clinical systems. Like many large health care providers, UPMC over the years has grown through acquisition of hospitals and other care providers, resulting in a mix-match of disparate clinical systems, such as electronic records and computerized physician order-entry systems. Doctors in hospital or ambulatory care settings will be able to quickly, easily, and securely access patient information, including medications, drug allergies, lab results, and immunizations, from data that comes from different electronic medical records systems used at UPMC, including software from Cerner and Epic, without navigating in and out of multiple systems and disrupting clinical workflow. Eventually, the interoperability will expand to include data from other EMR and clinical systems used by UPMC doctors and facilities. The kick-off of the live rollout will involve 45 providers at two emergency department sites, two busy primary-care ambulatory practices that include about 16 doctors, and a 10-physcian UPMC medical subspecialty clinic serving tens of thousands of patients. But in the months to come, the project will be rolled out across UPMC's 20 hospitals and 400 outpatient sites, doctor offices, and other care facilities. UPMC provides care to about 1.2 million patients. A "big part" of the project was "semantic interoperability," said Dr. G. Dan Martich, UPMC's chief medical information officer. That semantic interoperability helps eliminate confusion or misinterpretation between the meaning and context of common and similar terms such as blood pressure vs. hypertension, or drugs called by their generic names vs. brand names. To reach the goal of semantic interoperability, the data, messages, and documents from disparate systems are mapped within dbMotion software to common standards of meaning in a clinical data repository and transferred in a consistent manner into each of the source systems, according to UPMC. So clearly expressed common meaning of critical information elements such as allergies, medications, problems, and diagnoses from all data sources "will improve care by minimizing the chance that a provider will misinterpret, confuse, or not see essential information," according to an UPMC executive summary of the project. Ultimately, UPMC's goal is to improve patient quality of care and safety by improving access and interpretation of data, lessening the odds for medical mistakes, and tackling other issues. The complexity of the UPMC interoperability project -- because of the scope and variety of systems used by UPMC clinicians, is akin to the data-sharing challenges faced by other large health care providers nationally. Nationally, dozens of regional health information organizations, or RHIOs, are trying to figure out ways to safely and securing share critical data. Because UPMC serves such a large community of patients through so many facilities, "we consider ourselves our own RHIO," said Martich.
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