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● Electronic Health Records Integrating IT T


for next-gen EMRs Unifying disparate systems and content with the EMR helps providers operate more effi ciently. By Jared Blankenship, Hyland Software


he recent focus on sharing information externally between providers has overshadowed the impor- tance of sharing information among the integrated delivery network (IDN). When internal informa-


tion systems lack interoperability, clinicians do not have access to the complete patient record and pertinent information normally stored outside the electronic medical record (EMR). If this information is not readily available, mistakes can be made that put patients at risk. Integrated systems provide instant access to the most recent patient record, which helps clinicians save time, minimize risk and support proper patient care. According to surveys conducted by HIMSS, more than 90


percent of healthcare providers in the U.S. are using EMRs. T is, in turn, escalates the importance of existing IT systems’ integra- tion with EMRs. Aside from making organizations paperless, “next-generation EMRs” will integrate with existing systems and software tools, such as enterprise content-management (ECM) solutions, to provide clinicians and staff members with instant access to critical patient information. T is information includes documents, images and test results that the EMR typically can- not store but are imperative to patient safety and care. An example of an integrated, next-generation EMR is at


Sharp HealthCare in San Diego, Calif. When Sharp HealthCare began implementing its EMR, it also implemented an ECM solution to enable the inclusion of unstructured data within the EMR. As a result, clinicians could access all patient information when the EMR system went live. At Sharp Mary Birch Hospital, the second-busiest woman- and-infant hospital in the country, OB/GYNs fax changes to expectant mothers’ medical records to the hospital. T ese faxes are automatically imported into the ECM system and incor- porated within the EMR. When patients arrive at the hospital, they are quickly admitted and clinicians have access to the entire patient fi le, including the most recent medical information. In addition, Sharp HealthCare’s ability to effi ciently process faxes from external providers strengthened a relationship with a local medical group, which led to an increase in referrals and a 15 percent increase in new business.


Looking at the HIMSS EMR adoption model (EMRAM) as www.healthmgttech.com


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an EMR roadmap, ECM plays an important role in Stages 2 and 7. In Stage 2, ECM systems connect to the clinical data reposi- tory, enabling staff members to electronically access structured and unstructured content. Because that unstructured content constitutes nearly 25 percent of the patient record, integrating the EMR with an ECM solution provides clinicians and staff with the ability to see the complete picture from a single point of access. Such content includes forms, faxes, EKG waveforms, fetal monitor strips, exam results and DICOM clinical images. In Stage 7, ECM solutions work with the EMR to help


providers exchange information with authorized entities and eliminate paper processes. T e integration marks the end of disconnected systems and the beginning of a next-generation, connected enterprise – from registration and patient care to accounting and back-offi ce processes. Integrated systems help providers attain Stage 7 by eliminating paper charts, enabling the EMR to retain that crucial combination of discrete data, documents and medical images. Not only does this support information exchanges, but it also automates and streamlines labor-intensive, error-prone manual processes. When patients arrive at a Sharp Hospital, the admitting clerk scans their driver’s licenses and insurance cards. Patients sign an interactive tablet, which displays the hospital’s conditions of admission in English or Spanish. Admitting clerks print registra- tion packets for only those patients who request it. Otherwise, the registration process is completely electronic. As a result, staff and clinicians may see and act upon information before the patient physically arrives at that particular venue – and well before discharge. T e traditional approach to scanning and indexing clinical documents in an acute setting – using a paper chart during the patient’s stay and then collecting and scanning the chart centrally post-discharge – won’t meet Stage 7’s threshold of converting critical documents into electronic format within 24 hours of creation or receipt. Using ECM, organizations can create a combination of centralized and decentralized capture, allowing for point-of-care scanning and indexing for all clinically relevant documents, making them immediately available within the EMR.


HMT HEALTH MANAGEMENT TECHNOLOGY March 2013 13


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