A key feature of QIE, built with multi-enterprise integration in mind, is the inclusion of a workflow-driven forms-module that allows user input as part of the interfacing and integration process. This feature allows the physician to refine their query and request only the specific details that they need such as recent test and reports, sent either to a hospital known to have the desired data or to any hospital connected to the interface engine that may have information on the patient. This module, added to the data exchange request, turns the interface engine into a pinpoint search engine. And it routes the documents into the workflow of the clinician’s native EHR.
“If the interface engine is just an interface engine and doesn’t have this forms-module workflow component, then they’re confined to whatever the native functionality is of their EHR,” Shapiro explained. “And often that’s very restricting in being able to implement clinically relevant and efficient workflows.” Whatever search capability the EHR doesn’t support can be achieved using the QIE forms-module.
The real-time, bi-directional interfaces between the The Oregon Clinic EHR platform and the Epic platforms of two of the local hospital systems – Legacy Health and Providence Health and Services – has resulted in a more accurate and complete health record for all, which has improved patient outcomes, made the delivery of care more efficient, increased patient access to care and eliminated redundant costs and effort. A third interface connection pending with OCHIN, a hosted Epic installation for mainly community health centers and county health departments in the region, will add another source of rich information for doctors, according to Fitzgerald.
A physician can be in the middle of an exam when a patient mentions a test done at one of the hospitals a few days earlier. The physician can tell a medical assistant to query the hospital for that specific record, which comes back to the EHR screen a minute or so later while the exam continues. “That usability and quickness by the clinicians when they’re actively seeing patients was a critical piece” in the choice of interface engine, Fitzgerald said.
Meanwhile at Providence, primary care physicians and emergency department (ED) clinicians have access to the clinic records of patients being treated urgently or on rounds, according to Andrew Zechnich, MD, regional CMIO of the health system and practicing emergency physician.
Shortly after the interface went live, he saw a patient in the ED who was suffering from gastrointestinal bleeding and had recently seen a GI specialist at The Oregon Clinic. In the old days, prior to that interface, generally I would just do without that information,” even though the patient mentioned some completed tests, he explained. “I could certainly call them and have them fax some results over, but that’s a very time-consuming process on both sides,” he said.
Instead, he launched Care Everywhere from within his workflow to query what The Oregon Clinic had recently done and documented. “I was able to avoid doing duplicate tests and have a clear picture. So I saved the patient time, a needle poke, additional cost and I had immediate access to information,” said Zechnich. “And that has played out multiple times since then; in fact, I know for our providers, it is a daily occurrence.”