Focus is on coordination of care

ALBANY, NY – Albany Medical Center has set the stage to exchange patient clinical data between its electronic health record and the EHRs of its affiliated physicians. With one large physician practice connected last month, Albany Med has more in the pipeline.

“We will be transmitting a CCD (Continuity of Care Document) with discrete data via the protocols,” said George Hickman, executive vice president and CIO of Albany Medical Center, who is leading the project for the medical center. “We are now making this a reality as the first provider organization for our two vendors and as far as I know in New York State.”

Albany Medical Center recently moved its Direct infrastructure into production for Siemens Soarian and started production with Allscripts Enterprise in January.

As Hickman explained it, a patient’s clinical data – starting with a patient’s discharge summaries – can be securely moved over the Internet and "land" in the workflow tasking features of a provider's patient-specific EHR. It makes it possible for both parties to do away with paper faxes and mail copies, and the extra steps required to scan the paper document into the patients EHR.

The information “skips over the Internet – in a workflow, meaningful kind of way,” Hickman said. “Key to this thing, is that it is workflow-centric for the doctor. The data moves from EHR to EHR.”

Also, primary care physicians will be able to refer patients to specialists and get results back from the specialists.

It signifies progress for interoperability, collaboration – and coordinated care.

“The lack of coordinated care, one of the most pressing problems we face in healthcare, often stems from a lack of an appropriately secure flow of critical clinical information," said A. John Blair III, MD, MedAllies CEO. "This has a negative impact on patient safety, care quality and costs."

MedAllies serves as HISP – health information services provider – for the Albany pilot and for many others across the country.

Blair is a champion of the Direct Project, calling it a “groundbreaking” national effort, under the auspices of the Office of the National Coordinator.

“It represents a totally new way of doing business,” he said. He sees the initiative as benefitting providers and patients by improving the direct transport of health information, making it secure, fast, inexpensive and interoperable. “Advanced primary care models that emphasize care coordination and improved care transitions are enabled by this technology,” he said.

Hickman, too, is convinced that by providing data physicians can use will improve patient care.

To make it happen, “physician practices need to understand how the workflow elements of the exchange work for their respective vendors and do the necessary ‘build’ work with the EHR to allow it to package and send the care document to Albany Med's EHR as well as to receive and display our care document upon receipt,” Hickman said.

The data will be routed via the Internet with a service likely hosted by MedAllies, Hickman said, Also, the active physician rosters of the practices must be kept current with MedAllies’ record locator capability.

Exchange efforts that first started in New York State, soon expanded to other states. Last November a group of states and vendors eager to advance data exchange issued a set of technical specifications to standardize connections between healthcare providers, health information exchanges (HIEs) and other data-sharing partners.

EHR/HIE Interoperability Workgroup was originally formed by the New York eHealth Collaborative (NYeC). It is made up of California, Colorado, Maryland, Massachusetts, New Jersey, New York, and Oregon, representing about 30 percent of the country’s population.

“We started this as a New York State initiative,” said David Whitlinger, executive director of NYeC, “but we soon realized that many other states were facing the same interoperability challenges and many of the EHR and HIE vendors were also looking for clarity from the marketplace to define their product roadmaps.”

Blair describes the initiative as “a massive change management.” And, he adds, “There really is something in it for the doctors this time.”