By - Emel Hamilton, MD, vice president of Clinical Support and Informatics at Fresenius Kidney Care, knows interoperability and patient data exchange is not unique to the nation’s leading network of dialysis facilities.
However, due to COVID-19 and the need for enhanced interoperability, Hamilton and her team needed to make a fix to improve interoperability throughout Fresenius Kidney Care’s 2,500-plus facilities.
As a result, the massive care center recently connected to CommonWell Health Alliance and, subsequently, the Carequality interoperability framework to boost patient data exchange across its over 190,000 patients.
“Fragmentation of care is ubiquitous within the medical community,” Hamilton told EHRIntelligence. “Consider the patient’s clinical picture as a mosaic of information: Every provider holds a few pieces of this information, but nobody has the whole clinical picture. Even if the clinician receives faxes of discharge summaries or office notes, these records are often incomplete and missing important details of the patient’s medical history.”
According to Hamilton, the CommonWell connection aims to assemble the mosaic pieces to create a complete clinical picture at the point of care. And the kidney care division is always focused on reducing fragmentation and improving interoperability.
READ MORE: How to Optimize and Keep Up with the Evolution of Interoperability
“Fresenius Kidney Care believes health information exchange is one of many different potential solutions for improving quality, safety, and efficiency of healthcare,” she added.
Fresenius Kidney Care, a Fresenius Medical Care North America division, is the worldwide leader in renal disease treatment and kidney disease research. Their care team aids individuals with chronic kidney disease and end-stage renal disease, meaning they are serving high-risk patients during the pandemic.
But while Hamilton and her team always recognized the need for interoperability, COVID-19 put that need under the microscope.
“The current pandemic highlights the importance of interoperability as COVID-19 infections have created urgent health care instances marked with distress, pain, and suffering,” Hamilton explained. “These are the critical instances when clinicians need a system that will provide a patient’s complete clinical picture at the point of care.”
“As a result of the pandemic, we have included COVID-19 lab results under the microbiology section in our continuity of care documents to allow other providers to triage patients during transitions of care appropriately,” she continued.
READ MORE: How a Rural Hospital Got an Interoperability Boost During COVID-19
With the connection to the CommonWell Health Alliance interoperability network and its bridge to the Carequality interoperability framework, the Fresenius care team can locate, exchange, and view patient data from more than 600,000 providers and 2,800 hospitals across the country.
“The exchange enables the provider network to access dialysis treatment records for any patient treated at Fresenius Kidney Care and better coordinate care with patients' other participating providers,” said Hamilton. “Because people living with kidney failure often have multiple comorbidities, many are routinely treated in other facilities and hospitals outside the dialysis center, making access to health information critical.”
On the CommonWell network, Fresenius clinicians can access discharge summaries, laboratory, radiology, and emergency results. However, Hamilton said that merely joining the exchange is not the end of the story.
“It is easy to get enthusiastic about electronic exchange of clinical information between providers,” she said. “However, one must also remember that although HIE is an exciting frontier, it is still an emerging technology. There are numerous structural and technical challenges as well as barriers to acceptance and sustainability; these can only be resolved with active collaboration between the healthcare community and federal government.”
Using Fresenius’ existing Cerner EHR system, Hamilton said the EHR integration is crucial to gaining the full benefits from the expensive HIE implementation. The integration aims to boost operational efficiencies, patient care, and safety at its facilities.
READ MORE: COVID-19 Accelerating Interoperability, Data Exchange, Analytics
Medical practices that integrate and utilize HIE can decrease the number of emergency department visits and unplanned 30-day hospital readmission, according to a study conducted by HEALTHeLINK.
“Busy clinicians do not have time to log into separate platforms to retrieve patient information,” Hamilton continued. “In order to reap the benefits of this tremendous investment and generate value, we needed to put the information right in front of the clinician at the point of care. We were able to accomplish easy access to exchanged documents through the company’s existing Cerner technology for managing patient health records.”
Once the integration begins to roll out across the 2,500-plus facilities, the goal is to have the entire network live and connected by the end of the 2021 first quarter.
“The HIE project will launch in waves; we are rolling it out in select states and dialysis centers first,” Hamilton explained. “We want to take our time to listen to the clinicians and receive their feedback from the first wave of deployment. We will build use cases that support the team taking care of patients, and spend some time making sure that presentation of the HIE information fits well into the clinician’s workflow and that it is presented in a form that can be cognitively processed for decision-making.”
With a copious amount of patient data at their fingertips, Hamilton said it is time for their team to put the newfound data into action and focus on the valuable pieces to boost patient care at Fresenius.
“Our future focus will be on transitioning from interoperability to interoperation so that we make HIE a part of the clinician’s workflow and help deliver on its promise to improve health,” concluded Hamilton. “A lot of patient information flows in through the exchange. We will focus on filtering through the noise, present the information more meaningfully, and more specific to the role of the clinician.”
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October 26, 2020 at 08:30PM
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