Integrating two medical systems

  • Redesigned workflow

Charlestown, in Catonsville, Maryland, is home to over 2,500 residents and is the flagship campus in the Erickson Communities network. When Charlestown residents require ambulatory or critical care, they are normally taken to St. Agnes Hospital; just three miles from campus, St. Agnes is the closest emergency facility. Typically, a hospital patient’s medical records must be requested from his or her physician’s practice, at which time copies are faxed or sent to the hospital by courier or mail. In the meantime, tests and procedures may be unnecessarily repeated because of a lack of information, patients may fill out redundant paperwork, and key clinical data such as allergies and problem lists are unavailable. As a function of such problems, patients may be at risk. Audacious Inquiry works as part of an interdisciplinary team to develop a better solution using technology.

Eighty percent of Charlestown’s residents depend on the Erickson Health physicians’ practice for their primary care. Meanwhile, Erickson residents store their medical records in GE’s Centricity electronic medical records (EMR) system. The solution centered on how to make records from Centricity available in real-time for providers at St. Agnes.

Integrating clinical systems on a point-to-point basis is expensive and the model does not scale. Further complicating such projects is the fact that practice records are organized by patient while hospital records are organized by encounter (the EMR system at St. Agnes, for instance, holds over 3 million patient encounters). With such a high volume of patient exchange between Charlestown and St. Agnes, the two organizations decided to pursue an innovative solution for streamlining collaborative care. The team, led by Audacious Inquiry, included representatives from Erickson, St. Agnes, and HealthUnity, an Audacious Inquiry software partner based in Bellevue, Washington.

“The fact that we embrace cutting-edge technology is one of the many reasons that the Erickson Heath system is at the forefront of wellness and health for older adults in America today,” said Dr. Matthew Narrett, MD, Chief Medical Officer, Erickson Health. Erickson Health was an early adopter of electronic medical records (since 2003), and in 2005 started offering residents access to their medical records through a secure online portal.

With the support of Erickson, the team planned and built a health information exchange (HIE) using HealthUnity’s innovative technology platform. HealthUnity’s solution is on the cutting edge of healthcare informatics—it allows for critical clinical and demographic information to be shared across a network of providers, in a private and secure environment.

The HIE’s logical connection of disparate healthcare providers across decentralized data silos offers the scalability that point–to–point systems integrations cannot. Charlestown residents being treated at St. Agnes now benefit from their key records being immediately on hand. Incident reports from St. Agnes are also available to practitioners in the Erickson Health clinic at Charlestown for follow up care. Clinical data flows to the relevant points of care based on business and data-confidentiality rules set by the two sponsors.

The project was recognized as a finalist in the interoperability category for the prestigious 2007 Microsoft Healthcare User Group (MS–HUG) awards. Following the integration, a grant was also awarded by Governor Timothy M. Kaine to replicate the project at an Erickson Retirement Community and hospital in Virginia.