Q&A: NoVaRHIO starts interoperability process in the ED
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The pilot, called MEDS ED, provides Inova Health System’s Alexandria's emergency department (ED) physicians with patients’ medication history. “The largest access into any health system is through the ED,” so it makes sense to start clarifying and exchanging medication information where it’s needed most, said Geoffrey Brown, CIO of Inova. Brown, along with NoVaRHIO CIO Phil Reilly, recently spoke with CMIO.
CMIO: How does this pilot program work?
BROWN: When a patient presents in our emergency department with consent for medications, it is requested that we be allowed to check for medications filled by commercial pharmacies, which helps to ensure that a complete medication history is available to the practitioner, physician or nurse who is assessing the patient’s condition.
Under this pilot program, while the patient is going through the process of registration and assessment, a query goes out to a commercial database through our GE HIE environment, and connects with Surescripts [prescription information database]. There are two million patients within the Alexandria database, and we anticipate an 85 to 90 percent match with the patients we serve in our community. This all happens in less than 20 seconds and provides the health team with a more comprehensive profile of the patient’s medication history. To facilitate this process, our hospital information system is GE Centricity Enterprise, and he ED application at Inova is the PICIS Pulse Check.
If there is a discrepancy, it can easily be seen. There is a certain amount of built-in filtering that is designed to eliminate duplicate presentation of medication information.
REILLY: With the patient’s permission, caregivers will start collecting that information and entering it into the system. Alexandria [is] geographically compact, so it lends itself to this kind of a program.
CMIO: Will this pilot program transition to EDs only, or are you talking about facility-wide use?
BROWN: We’re looking primarily at making this information available to other hospital EDs and physician partners. The Inova vision is that this option will be made available, with patient consent, throughout the Inova delivery system.
Once perfected at the ED level, this data exchange can be made available to other trusted sources. We’re starting with medications, but that list will expand to include allergies and other treatment information that could be useful in the treatment of patients.
CMIO: What is NoVaRHIO doing with regard to sustainability?
BROWN: Not all physician practices or clinics are affiliated with a hospital, some of them are stand-alone. There may be instances in which a physician would like a contractual relationship with an independent service to broker [health information exchange] in their behalf.
Hundreds of millions of dollars are being spent across the U.S. on systems that do not communicate with one another. Organizations, like NoVaRHIO, will enable data exchange to occur among physician practices and other entities that operate outside health care systems like Inova.
REILLY: We’re reaching out to the business community to get business leaders more involved, showing them the benefits to their employees. They’re paying health insurance premiums; they’ve have a vested interest. We also want to bring insurers into this process.
NOVaRHIO is also seeking to explore the possibility of working with the Veterans Administration and Department of Defense health systems in its efforts to broaden the utilization of electronic health records.
CMIO: The pilot has been online for about two months at this point. What results do you expect to see in six months or a year?
BROWN: We will have the ability to take structured information and make it useful, then share it as these gateways open up. Only about 12 percent of physician practices have EMR systems today. Capturing information in an EMR and making this information available to other systems will allow implementation of evidenced-based protocols. This is often discussed under the subject of interoperability.
We believe the results of this pilot will lead to significant improvement in care management.