The path to interoperability involves more than EMRs

Susan deCathelineau, Vice President of Healthcare Sales and Service, Hyland, creator of OnBase
Susan deCathelineau, Vice President of Healthcare Sales and Service, Hyland, creator of OnBase

Dr. John Halamka recently discussed interoperability in his blog, where he said, “It’s time to step back, define our requirements, examine our current state, and then focus on closing any gaps we find.”

I agree with Dr. Halamka.

Interoperability can be daunting without clear definitions and patient-centric goals. However, we can easily identify some gaps and work to solve them now.

Imagine a world where patients enter the waiting room and their consent forms, identification and insurance cards, previous test results, X-rays, MRIs and any other relevant content, were already accessible to the clinicians and staff. It would be a revolutionary turn of events considering healthcare organizations are closely looking at patient satisfaction ratings. 

I’ve talked with numerous CIOs and CMIOs who are aware that patients are going to doctors both inside and outside of their system. These same leaders agree that patient information is critically important to patient care and it should be accessible to clinicians wherever patients can find the best care and outcomes. What I love about these conversations is that the patient is the focus of the discussion. If this wasn’t the case, it might have been the most difficult common denominator to achieve. Since the patient is the central concern, it should be easier for us to determine the requirements of interoperability and how we reach our goals.

Many of the conversations regarding interoperability have been focused on electronic medical records (EMRs). I find that interesting since my colleagues and I estimate that nearly 65 percent of the patient record is stored outside of the EMR. The conversation shouldn’t focus exclusively on EMR interoperability, it should also include the other 65 percent of content and the corresponding systems, including enterprise content management systems (ECM) vendor neutral archives (VNA) and picture archiving and communications systems (PACS). These systems contain some of the most valuable patient information, including patient consents, MRIs, X-rays, CT scans and more.

ECM systems recently added VNA and information exchange capabilities that solidify its position as an enterprise solution capable of securely capturing and storing content, integrating with EMRs and sharing the information with other healthcare organizations. When there is a transition of care, patient content simultaneously and electronically transfers to the next organization. Transporting records no longer falls to the patient, and clinicians no longer need to start from scratch to manually construct a collection of patient data. This clinical content strategy is essential to the health data continuum, providing healthcare organizations with the roadmap to improved patient care.

Some EMRs facilitate information sharing, but the clinical content is limited. With up to 65 percent of patient information residing outside of the EMR, quite a bit of content is left out. In order to share this content with another health system or provider, healthcare organizations must print, copy, scan, fax or deliver the information. This less-than-optimal practice adds expense and time – which in emergency situations, may be in short supply.

Healthcare organizations within the OnBase ECM community can request patient records from one another, either by using a link within the EMR or through the OnBase Patient Window. It quickly and securely shares the requested information, providing clinicians with a more complete patient record – including results, reports and images, like CTs, MRIs and X-rays – in context with other relevant patient content. This quick access to patient information supports more informed decisions empowering clinicians to provide more confident patient care – without having to order repeat tests, cutting costs.

Access to a patient’s current medications, allergies, lab and test results and equal, simultaneous access to all clinical imaging content encourages collaboration among clinicians and elevates the patient experience. Making it easier to share information makes it easier for clinicians to focus on patient care and make the best decisions based on more complete patient information.

The industry’s interoperability efforts have come a long way and although we have a long way to go, I’m excited about our trajectory.

ECM, electronic medical records, EMR, enterprise content management systems, Hyland, interoperability, OnBase, PACS, picture archiving and communications systems, vendor neutral archives, VNA


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