Addressing physician concerns about Salem Health withholding health information

29 May 2016

By: Cheryl Wolfe, CEO and president of Salem Health

 

Some medical staff discussions recently have centered on the question “Is Salem Health withholding patient care information from the community?”

This is an important question that deserves a straightforward answer. Salem Health is not withholding patient care information from the community. Let me explain why.

Salem Health has been working towards “one patient one record” from the beginning of the Epic journey. This means that all of the patient care data should be on the same record for ease of use, retrieval and continuity. This gives all providers access to the same information and results in better patient care.

That being said, the reality is the community is not all on the same record system. There are multiple EMRs in the Marion/Polk region. There are options to exchange this data: point-to-point (interfaces custom built between the two parties) or Health Information Exchanges (HIEs) that all EMRs attach to a central core and the core exchanges the data.

Interfaces are one-to-one connections that have to be built to custom specifications. They require highly skilled people, are expensive and slow to obtain. The maintenance of individual interfaces is also expensive for the same reasons. The advantage to an HIE is the EMR connects once, maintains one connection but the core is attached to thousands of EMRs, thus it achieves the same data exchange with only one connection.

The data that is most desirable to exchange is incorporated in a Continuity of Care Document (CCD). Many of the elements of the CCD are standardized and all Meaningful Use certified EMRs are capable of producing a CCD.

Salem Health was an early adopter of Health Information Exchanges and joined eHealth Exchange (now part of the Sequoia project) and SureScripts (e-prescribing vendor) when it was made available. Epic also has a set of functionality called Care Everywhere that exchanges to other Epic EMRs using the same technology. This allows for exchange of a standardized set of information (CCDs) to all parties attached to eHealth Exchange, SureScripts and Epic EMRs. The result of this is that all EMRs can obtain CCDs without a point-to-point connection (interface), which lowers the cost of installation and maintenance.  Salem Health has exchanged millions of records via these mechanisms to date.

Salem Health was asked by the medical community to provide notification of primary care, admitting and attending providers that their patient was seen in the ED the day before or discharged from the hospital the day before. This is achieved with daily emails.

Salem Health has a comprehensive lab information exchange for community providers and is currently building a radiology interface for MVPs version of Nextgen. The HIEs above will not handle this type of bidirectional order.

Salem Health has extended its instance of Epic to Salem Clinic in order to provide for patients in a more seamless fashion. This moves our community towards the goal of achieving “one patient one record.” Salem Health is committed to continuing this Community Connect work with additional partners and has built the team and technical infrastructure necessary to do so.

If your clinic is interested in exploring Epic please contact Leah.Mitchell@salemhealth.org. Salem Health has a process to explore the opportunity and to determine the financial support that can be obtained. There appears to be misinformation about this process in the community and we welcome an opportunity to explore this with you.

If Community Connect is not of interest to you, we encourage the use of one of the available HIEs so that we can exchange patient data in a meaningful way.