Northwest Indiana hospitals continue to embrace electronic record keeping, but sharing that information among different hospitals is more than just a keystroke away.
Epic Systems is a commonly used electronic medical records software in the Region. Hospitals using that software and an application called EpicCare Everywhere have the ability to view patient records from other participating systems.
"Currently, we can only share information electronically between Epic hospitals if a patient consents and the request is made by the physician," said Matt Doyle, chief financial officer at Methodist Hospitals. "A patient can also request a copy of their medical record chart from our medical records department if they sign a release."
Doyle said if a patient enters an emergency room and tells staff about a recent stay or testing done at a different hospital, the physician could electronically request information from that hospital.
"A report with the patient’s information such as allergies, and most recent test results could be accessed by the physician," he said. "There is no way for just any health care worker to access patient data from another facility."
Patient consent is needed, to maintain patient privacy compliance.
"There are technological considerations and issues surrounding trying to share data between Epic and non-Epic hospitals or physician offices that do not run the Epic Ambulatory module," Doyle said. "These issues are related to ensuring that we have documented patient consent as well as interfacing data between two dissimilar systems. It can be done, but it requires resources and effort on each side of the interface. We expect technology to be developed to allow this to happen."
As government policies call for increased use of electronic records and data sharing, Indiana is advanced, said John Kansky, executive director of the not-for-profit Indiana Health Information Exchange.
The group partners with Indianapolis-based Regenstrief Institute, which had been doing health information exchange work since the '90s, he said.
"The good news is that Indiana is the furthest along and most sophisticated and most invested in any of the 50 states," Kansky said. "Indiana is the most connected in the country."
Most hospitals in the northwest corner of the state are customers of the Indiana Health Information Exchange and are in a stage of implementation, he said.
"We're connecting the hospitals and other settings, regardless of what system they have," he said.
Participating hospitals have access to shared data. Patients who walk into a hospital that is live on the Indiana Health Information Exchange will have their background available to health care workers, showing them information about medications and recent medical visits, for example, Kansky said.
Although the information exchange is nonprofit, participating hospitals pay a fee, based on the hospital size.
Kansky, a Highland native, said he is aware many people cross the state line for care.
"There are health information exchanges emerging in Chicago and the state of Illinois, and we're in conversations with those folks," he said.
Kansky said electronic record systems help unite information and benefit doctors in a certain organization, but patients don't always seek care from only one organization.
"That's what the health information exchange is for," he said.
Ramona Fissinger, vice president of health data support services at Community Healthcare System, said implementing Epic was a huge undertaking.
It took 18 months to get all three hospitals and a majority of physician practices on board, she said.
Most hospitals use the EpicCare Everywhere feature, she said, but staff have to be cautious about ensuring the information is for the same patient.
"We have to be very careful, because you don't want it to be incorrect," she said.
If the patient information, such as Social Security numbers, don't match, the hospital contacts the health information management team, she said.
Penny Scott, clinical informatics manager at Franciscan St. Margaret Health, said there is some frustration from providers, patients and staff that society is not at the point where there is universal easy access to health care information.
"Our physicians in this area are fortunate in the fact that many have only needed to learn the Epic application to function in the hospital systems," she said. "There is an issue and some discontent though in that some providers may have chosen to purchase other software vendors for their office practice. There currently is not an interface for all the different vendors software to connect seamlessly and make it ideal for everyone to use and obtain information."
Scott anticipates great strides in the next few years, with vendor applications, health information service providers and health information exchanges.
"Improvements will be in the future when the electronic transfer of information across multiple healthcare software vendors is accomplished which is the ultimate goal," she said.