Carolina Cape Fear Medical Group, based in Fayetteville, North Carolina, had a problem: Clinicians lacked a full view of their patients' medical histories.

THE PROBLEM

The medical group is located near a military base, so it often sees patients who have been cared for by multiple hospitals across the country. In addition, COVID-19 has brought about a significant shift in healthcare over the past year and a half, with people being limited to telehealth visits and reaching out to more than one provider.

"These changes increased the significance of getting access to timely and holistic information for our patients," said Trish Haynes, practice manager at Carolina Cape Fear Medical Group. "Without easy access to full records, we relied on our history with the patient or their memory of previous medical procedures.

"Inconsistent and unreliable information can not only result in providers spending more time on paperwork, it can prove to be harmful or even life-threatening for our patients," she continued. "Our practice was looking for an automated solution that could enable us to examine a patient's full medical records from across the U.S., providing the highest quality care to anyone who walks through our doors."

Additionally, patients often come into the practice with urgent medical needs. Quick and easy access to external medical records is vital for clinicians to provide adequate care in a timely manner.

"From patient check-in to checkout, my staff no longer waste time contacting other providers or combing through enormous amounts of data, and can shift their focus back to advocating for their patients."

Trish Haynes, Carolina Cape Fear Medical Group

"When patients are in pain or nervous about a medical issue, it can be hard to remember previous treatments and procedures," she explained. "As a result, our staff often has to contact former providers and payers to piece together a holistic care history that allows for a diagnosis. This lengthy process could be detrimental to a patient's health and create unnecessary roadblocks in treatment."

PROPOSAL

PRISMA, the health information search engine from EHR vendor eClinicalWorks, offered Carolina Cape Fear Medical Group a comprehensive search tool to streamline data from multiple sources to create an integrated patient record, Haynes said.

"Today, we have access to massive amounts of data coming in from different sources – like primary care practices, specialists, wearable devices and more," she noted. "We have more patient information available than ever before, and we need to quickly access and analyze this information for better patient outcomes.

"When eClinicalWorks introduced PRISMA into our system, it was a seamless addition to our workflow, and I noticed how it instantly helped our providers make quicker and better decisions," she added.

Healthcare has an ever-changing and collaborative landscape, and medical groups can leverage advanced technology to avoid the tedious back-and-forth between a variety of providers.

Carolina Cape Fear Medical Group's medical staff also needed a timeline of past procedures and tests to make accurate diagnoses and improve the patient experience. By knowing exactly when patients last received treatments and/or medications, staff can be mindful of the patient's time and money, Haynes said.

"Some patient records can be hundreds of pages long, so we were looking for a solution with a search function so our staff could drill down to any specific type of information they need on a given patient," she said. "This way, we can prioritize information, save time and supplies, and reduce costs of unnecessary tests to determine the health issue.

"From patient check-in to checkout, my staff no longer waste time contacting other providers or combing through enormous amounts of data, and can shift their focus back to advocating for their patients," she added.

MEETING THE CHALLENGE

Haynes said it was easy for medical staff to start using PRISMA.

"In an instant, the technology was available to everyone in our practice without any major legwork – from the front desk staff, who use it to check patients in, to the clinicians looking at in-depth lab reports and identifying the proper diagnosis," she said. "Everyone in our facility benefits from the comprehensive search tool.

"We have several large hospital systems in our area, including Cape Fear Valley Medical Center, Womack Army Medical Center and the Veteran Health Administration, and PRISMA helps us collaborate efficiently to provide the best care to local residents that come from all around the country," she continued. "Our insurance staff also uses PRISMA to help share medical records with payers and minimize unnecessary costs and procedures."

The tool has already been put to the test in the practice and has passed with flying colors, she reported.

"We recently had a new patient come in with ulcers in need of immediate attention," she recalled. "Since he was new to our practice, he didn't have any medical records. With PRISMA, we saved the patient from additional studies and images, and provided care immediately.

"The tool also compiled recent lab results and other relevant information to help coordinate with the patient's insurance company and move forward with the necessary procedures," she continued. "Without access to this search tool, our providers may not have been able to treat this patient in such a timely manner, potentially resulting in the loss of his limb."

Time is a precious resource in healthcare, and the information search engine allows staff to use their time effectively, Haynes added.

"Our staff now runs like a well-oiled machine, and we're seeing far less burnout, since providers are spending less time sifting through mountains of data," she noted. "As practice manager, I have peace of mind that Carolina Cape Fear Medical Group has all the right tools to meet our patients' needs. Our patients always come first, and the tool helps us provide the best clinical care possible."

RESULTS

Being able to access eClinicalWorks' information search engine has given the medical group greater insight into each patient.

"In just one month, we achieved an 87% hit rate by requesting external records on 2,300 patients, on average receiving about 32 external documents per patient and 65,148 documents in total," Haynes reported. "With better access to external sources, we have a holistic view of each patient and understand the intricate details of their medical history.

"We no longer rely on a patient's memory to fill in the missing information," she continued. "This helps us make informed decisions internally to improve care systems and procedures."

She added that the medical group is better connected, not just with local hospitals and healthcare facilities, but also with providers across the country.

"We've received documents from more than 130 unique sources, from more than 20 different states, in just one month," she said. "For the first patient in North Carolina we looked up using PRISMA, we received records from the University of Miami Hospital in Florida. Our world is more connected than ever, and the search tool is bringing the healthcare industry into the next phase of care, powered by technology and smart data."

ADVICE FOR OTHERS

Healthcare systems and facilities of all sizes need to be more integrated nationwide, Haynes asserted.

"Sharing of information is what will take us forward into 2022 and beyond," she said. "We provide one of the most important services to society, so creating a centralized and integrated platform is the only way we can continue to optimize patient care and outcomes. Unless we all open ourselves up to collaboration, the healthcare industry will continue to lag as more and more industries take advantage of information-sharing tools.

If her practice had this comprehensive information search tool a year ago, providing care during the height of the pandemic would have been significantly easier, she contended.

"Now, we can't imagine our day-to-day operations without it," she concluded. "As we face the rise of the Delta variant, we know we are prepared for whatever challenges come our way. If we want to improve patient care, reduce physician burnout and discover new ways of meeting our patients' needs, we must embrace technology that fosters collaboration, delivers actionable insights and always puts the focus back on the patient."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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