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Independent Clinical Archive Brings Complete Patient Record Together in One Place

Posted on October 27, 2017 I Written By

The following is a guest blog post by Tim Kaschinske, Senior Product Manager, North America, BridgeHead Software.

How many photos and documents do you have stored on your home computer or in the cloud? How easily would it be to find those photos of, say, the family beach vacation you took in 2010? What about the trip in 2001? Most of us would have to search blindly through scores of electronic file folders and myriad devices before finding what we need.

Now think about your physicians who need to access historical patient information, such as baseline mammograms, medication history, lab results or the course of a patient’s cancer treatment. Nearly every hospital is on its second or third EMR, and any new EMR vendor wants as little previous data to come over from legacy systems as possible to help ensure a “clean” install. So that leaves physicians and assistants poring through older EMRs, or other applications and media to find needed data. This takes time away from direct patient care, an increasingly critical consideration in value-based care arrangements.

But that older information still has value, for both patient care as well as for regulatory reasons. The problem, then, is how to store, protect and share that information in a way it remains readily accessible, available and readable even as technology changes.

Disparate data, common archive

The answer is an independent clinical archive (ICA) that can accept disparate data from multiple systems such as an EMR or a PACS and store it using open data standards commonly found in healthcare. An ICA does not replace an EMR or a PACS – it works in concert with them, allowing a hospital to formally retire previous EMRs, PACS and other IT systems while ensuring the electronic patient data contained within lives on as part of the 360-degree patient view. This saves money on licensing fees, storage costs and IT personnel costs to maintain and update rarely used technology.

An ICA is a centralized, standards-based data repository that ingests disparate data types such as DICOM images, HL7 reports, physician notes and other unstructured data. Information is managed based on unique patient information and further subdivided by specialty or date, for example. The ICA works best when integrated with a hospital’s EMR (via an application programming interface (API)), allowing providers to seamlessly compile a complete, longitudinal patient record without having to remember additional log-ins.

APIs are also used to connect to multiple legacy systems. However, security protocols on legacy systems are not as stringent as they are with newer technology, leaving hospitals potentially vulnerable to accidental or intentional data breaches. A hospital using an ICA as a central data repository only requires APIs among the ICA, the EMR and the PACS. Plus, the ICA has built-in security and protection features to ensure the safeguarding of critical patient data.

A true, 360-degree patient view

When an ICA is properly implemented, providers access the information being populated from the EMR and the information coming from the ICA through one system and in the appropriate context for the patient. And that’s the holy grail of patient information: one environment aggregating all of the information outlining chronic conditions, physician notes, medications, diagnoses, surgeries and much more.

And if a physician needs to drill down into radiology reports, for instance, he can pull up just that data. Finding information about a specific hospitalization is as easy as inputting the correct date range to locate just those records.

While Software-as-a-Service revolutionized the delivery of IT services, an ICA can revolutionize the way physicians find all of the data they need, quickly and within their normal workflows. At the same time, hospitals can save money and increase data security by retiring older electronic systems.

Hospital Competition Hinders HIE – Some Solutions to the Problem

Posted on July 31, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In response to my post about the Real HIE Problem, Tim Dunnington provided this powerful insight into a major challenge that are faced by HIEs. However, more importantly, Tim provided some suggestions on how to solve the problems.

I work for an HIE system vendor, ICA. One of the challenges we see our HIE’s face is FUD (Fear, Uncertainty and Doubt) around sharing patient data. The fear arises in sharing data with other participants that are direct competitors. The competition between participants can lead some participants to refuse to share “their” patient data with other participants, creating complex sharing rules based on these relationships, and meaning that the view of a patient’s record will change depending on what facility you happen to be in. This results in the patient’s medical record not being complete. The patient, meanwhile, is not aware of these nuances and is not aware that their record is incomplete due to these competitive issues. I can’t say we have an answer as to how to solve this, but it’s definitely a potentially large roadblock, larger I think that EMR adoption itself.

I would say in response to these issues:
* The EMR determines what data is shared, so you (as a customer of the EMR) should have some control over what exactly is shared and when
* The HIE will not by any means have a “complete dump’ of your database; the EMR sends out a limited amount of data about the patient or the encounter
* The interoperability standards are set up to keep participants from attempting what I call “patient surfing,” keeping the availability of data to those patients for which you have an established relationship. This means that your competition cannot simply download every one of your patient records, as they have no access to a means to query for all your patients.
* Auditing and regulatory measures ensure that attempts to access records for purposes other than direct patient care are caught and properly sanctioned.

I’d love to hear your thoughts and perspectives on the challenge of data sharing in a HIE. Do you think that Tim’s suggestions are good?