Are our EMRs talking?

Douglas A Koekkoek

Doug Koekkoek, M.D.
Chief medical officer, Oregon
Chief executive, clinical services

April 16, 2014

Thanks to Epic and other electronic medical records, we can instantly access order sets that prompt evidence-based treatment, see registries that track outcomes and get real-time decision support that checks allergies and prompts warnings. Just as important, these systems finally provide what has eluded medical practices for years: medical records continuity.

While Epic provides a single, seamless medical record for patients seen at Providence clinics, the reality is that only about a quarter of our credentialed physicians are Providence employees. For practices on Centricity, e-ClinicalWorks, Allscripts, Greenway or other EMR systems, connecting to aligned hospital partners can pose a challenge.

What’s a health information exchange and can your office connect?
Federal Meaningful Use revenue is available for practices that use certified EMR systems. While most of the MU criteria have to do with the functionality of the EMR itself, several components of stage 2 MU refer to the interoperability and exchange of information between health care providers.

The Portland market is unique in some regards because many of our large systems have adopted Epic or have used the Oregon Community Health Information Network to access Epic. In addition, Epic Care Everywhere provides a functional way to pull health information from other systems or providers into a current Epic visit.

Providence provides Epic Care Link to offices on non-Epic EMRs so that providers can place orders and referrals directly online. Using secure direct messaging to exchange documents is available through a number of third-party companies such as Surescripts. Direct messaging often is provided for a nominal per-document cost and may be the easiest way for private practice EMRs to meet the MU stage 2 criteria for interoperability.

Connecting to a third-party health information exchange, such as Healtheway or the Jefferson HIE, is another option to connect your office’s health information to other providers. In rare instances, direct HL7 (Health Level 7) interfaces can be built to connect different EMR systems.

We have much to learn about how to best connect our various IT systems. The work is not simple and, frankly, it’s outside the expertise of most physicians, including me. But across this changing technology market, Providence is committed to work with practices to find the best solutions that help them meet Meaningful Use criteria and provide our patients a connected experience of care.