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Thought Leaders

Integrated health record can show meaningful use

A multi-source SaaS platform combines labs, meds and hospital records to offer more to improve the quality-of-care coordination and patient safety than a traditional EMR.

By Ravi Sharma M

ost physicians believe that, to show mean- ingful use and qualify for government incentives, they will need an electronic medical record (EMR) system. This may not be accurate, because several EMR systems on the market today may not certify as EHR Technology under meaningful use largely due to limitations of the client- server architecture. A new type of application known as an “integrated health record” (IHR), offered in a Software-as-a-Service (SaaS) model, may include all the necessary components to demonstrate meaningful use. The IHR provides better connectivity and discrete data in comparison to the capabilities of traditional EMRs. Considering the IHR’s patient-centric data structure, which accepts information from multiple sources, and its decision support, the IHR may actually offer more to improve the quality-of-care coordination and patient safety than a traditional EMR.

The IHR shares a common platform between its dif- ferent components such as lab and radiology ordering and results, electronic prescribing, and hospital results and other documentation, making it easier to correlate a patient’s data and present it at the point of care. When combined with the ability to normalize data from multiple sources, and easily access it over the Web, the IHR enables providers to benefi t from a more complete, patient-centered record that transcends disconnected data silos and provides a unifi ed, continuously updated view of each patient-care episode.

While the IHR can be used on its own, it also can be used to augment an existing EMR system by provid- ing connectivity. In addition, the IHR can be used for patient referrals and is capable of supporting the conti- nuity of care document (CCD), a standard format for data exchange among healthcare providers and HIEs. Interfaces with practice-management systems also al- low the automatic transfer of patient demographic and insurance information to the IHR, making it seamless for the providers.

Conventional EMR systems lack connectivity with most ancillary providers such as the laboratories and

26 October 2010

imaging centers. As a result, practices with EMRs must still fi ll out paper requisition forms and even receive results/reports on paper from different labs or radiol- ogy centers with which they work. Besides the missing discrete data in EMRs, the errors and omissions inherent in paper-based orders often lead to delays and potential errors in testing. Unless a practice has costly interfaces with each lab or imaging center, it must scan the results into the EHR, limiting users’ ability to retrieve and utilize discrete data.

In contrast, a Web-based IHR overcomes such con- nectivity issues with multiple service providers and can capture the orders easily with much higher accuracy. The IHR utilizes decision-support tools to help physi- cians choose the appropriate tests, provide complete information required, create necessary forms and labels and transfer the orders electronically. This helps to avoid errors and delays associated with handling paper orders. The entire cycle of processing orders and return of results is faster and more accurate. Nothing is ever lost, and every test is tied to the correct patient.

Due to its inherent architecture, the IHR can utilize decision support to help physicians make more informed decisions. An example of that is the electronic prescribing that is a key component of an IHR. Leveraging Sure- scripts connectivity, the IHR provides online insurance eligibility, formulary and medication history informa- tion. Allergy and drug interaction alerts and therapeutic alternatives are included. In addition, an IHR can check for drug-to-lab interactions for selected patients and even graph medications against lab data, a feature that is lacking in almost all ambulatory-care EMR systems and standalone e-prescribing solutions. This longitudi- nal record helps physicians determine how well their prescriptions are working, especially for patients with chronic diseases.

Another key component of an IHR is its ability to provide census-based access to hospital data to the physi- cians using the same Web-based platform. Available in most hospitals from legacy systems, this data is not easy to access at most institutions, except on paper, and it is


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