San Diego-based Sharp HealthCare, like hospitals and health systems across the country, faces the challenge of ensuring a patient's electronic medical record is accurate and complete, and does not have a duplicate anywhere in the system. Sharp has taken significant strides in combating this issue through a data mapping program using a systemwide health information exchange, according to a case study compiled by the College of Healthcare Information Management Executives.
Hospitals within the Sharp system are using Cerner's EMR systems, while the system's physicians and affiliated medical groups are using Allscripts. Data is not easily exchanged between the systems because of the different storage structures. "It’s like comparing Macs to Windows-based computers," said Betsy Ellis, principle application analyst in Sharp's interoperability department, in the case study. "They use different code sets and different dictionaries. Cerner may code an allergy to peanuts one way, and Allscripts may code it an entirely different way. As each application evolved, they used these different codes and standards."
To solve the problem, Sharp implemented a systemwide health information exchange to pull information from the EMRs to a central data warehouse for storage and analysis. "We're not exchanging data between the two systems…we're mapping the data into our HIE for a common view," said Elizabeth Renfree, Sharp's director of interoperability, in the case study. Clinicians can then access a patient's records through the HIE, and be assured of seeing the complete, and only, picture.
To further reduce the instance of duplicate medical records within the health system, a 10-person master patient index department investigates patient identity issues. Created in 2001, the department has helped the health system reduce the number of duplicate records created from 18 per day to 4 per month. The department also proactively works to identify duplicate records before the patient seeks treatment and it becomes an issue.
Sharp officials realize more work lies ahead as the system as San Diego develops a regional HIE. "Patient matching across the community segment will be really difficult for just about everybody," Ms. Renfree said in the case study. "Protecting privacy and security is important; doing it is technically difficult and organizationally difficult, but it's all to the benefit of the patients."
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