Mercy Health Bridges Hospital Data Silos with Over 600,000 Medical Records Exchanged Monthly
Sharing of medical records has long been a healthcare model desired by patients. Below, we examine how Mercy Health in the United States has achieved the exchange and sharing of medical record information.
Mercy Health is a hospital consortium designed to integrate multiple hospitals into a comprehensive, continuous healthcare delivery system. One of its primary objectives is to ensure patient safety through the sharing of clinical information. Whether patients seek care at public health institutions, such as the Mayo Clinic, or require emergency services, they can access their historical medical records for reference.
The importance of medical record sharing, as well as the value of information sharing in improving service quality, is self-evident. Dr. Stephen Beck, Chief Medical Information Officer at Mercy Health, stated that when sharing information across different systems or within a single system, one discovers the vast amount of useful data that exists. The types of information that can be extracted vary depending on the specific sharing methods employed.
For many years, Mercy Health has leveraged Epic’s “Care Everywhere” initiative to ensure that all patients receive optimal care, predicated on healthcare providers accessing the right information at the right time. For individual patients, Mercy Health enables every component of the healthcare delivery chain—including emergency departments, surgical centers, and internal medicine practices outside the state or beyond conventional health systems—to access patient information. Going a step further, Mercy Health has established an Advanced Record Location system, which facilitates the identification of patient medical records without the need for manual retrieval.
Simple Exchange and Sharing
Mercy Health’s health information exchange program enables the sharing of patient medical records among clinicians within Mercy Health, as well as with other departments or organizations, including:
Organizations Using Electronic Medical Records Provided by Other Vendors
Health Information Service Provider (HISP)
Health Information Exchange (HIE)
Electronic Health Communication Organization
Government agencies, such as the Department of Veterans Affairs, the Social Security Administration, and the Department of Defense
In the first four months of 2015 alone, Mercy Health exchanged 2.5 million medical records. The organizations with the most frequent interactions included UC Health, TriHealth, The Christ Hospital, Cleveland Clinic, and Cincinnati Children’s Hospital and Medical Center. Since the launch of the “Care Everywhere” initiative in 2012, Mercy Health has exchanged over ten million medical records, involving 234 departments or organizations across 48 states.
Mercy Health has been able to achieve the exchange and sharing of ten million medical records, partly due to enhanced connectivity with government agencies. For example, Mercy Health began data sharing with the Social Security Administration (SSA) in January 2015 and has since successfully completed information exchanges for 8,871 medical records. Additionally, Mercy Health established connectivity with the Department of Veterans Affairs (VA) in March 2015. Currently, Mercy Health is working to establish connectivity with the Department of Defense (DoD).
Patient data exchange through the Social Security Administration (SSA) is relatively straightforward. When patients file for disability benefits, a signature is required to generate a record. Previously, Mercy Health completed this process using paper documentation. With the establishment of a shared system, this process is now automated, eliminating the need for involvement by physicians and related staff. Once a patient authorizes the SSA, Mercy Health’s system receives an electronic request and automatically performs patient matching. If the match is successful, indicating that Mercy Health’s system retains the patient’s medical records, the system will automatically transmit the medical information back to the SSA, creating a win-win outcome for both parties.
The errors that once occurred during information exchange via paper-based records are now a thing of the past. With just a click, Mercy Health clinicians can access this powerful shared system, which facilitates automated information queries. For instance, we can configure the system to locate patients within a 100-mile radius and cross-reference their data with other participating organizations to determine whether new records have been generated and require exchange.
The goal of this shared system is to break down barriers between different organizations, reduce redundant healthcare consultations and tests, and enhance capabilities to make the entire patient journey smoother and simpler. With this system, patients no longer need to recall test results or visit locations from previous appointments, and staff members no longer need to worry about sifting through large volumes of paper documents to exchange relevant information.
Benefits of Exchanging Non-Contiguous Data
Reaching consensus on data exchange in a given domain offers additional benefits. One of Mercy Health’s key initiatives in collaborating with other Epic partners has been the exchange of discrete data elements in the following three areas:
Disease List
Medication
Allergy
If a patient visits an emergency department within the Mercy Health partner network and subsequently receives follow-up care at a Mercy Health primary care site, Mercy Health can access a comprehensive view of the diagnostic and therapeutic services the patient has received. Should new medical conditions arise, staff members can simply click the designated interface to integrate these conditions directly into the patient’s existing problem list, medication records, or allergy history, eliminating the need to create a separate record.
As Mercy Health continuously collects data over time and shares this information across communities and between points of care, what is its significance? Could it not help healthcare providers reduce the frequency of asking the same questions? Could it not help patients avoid repeatedly answering the same questions? With such a system in place, clinicians can directly access a patient’s complete historical records, allowing them to easily say, “I see that you are allergic to penicillin. Are you allergic to anything else?” Would this not streamline the inquiry process?
This system can reduce the memory burden on patients, thereby also reducing recall bias in medical activities. In fact, it is difficult for patients to remember the specific year in which they underwent knee surgery. With a health record exchange and sharing system, in the near future, patients will no longer need to worry about forgetting detailed visit information, and physicians will no longer need to ask questions about details that patients have already forgotten. This is one of Mercy Health’s key priorities.
It should be clarified that Mercy Health aims to achieve information sharing, i.e., the exchange of information between two points. Operationally, it functions more like a network query system rather than a nationwide electronic medical record database or information repository available for queries across China.
Success and Challenges
Mercy Health’s success extends beyond its partnership with Epic. In February 2014, Mercy Health initiated its first non-Epic patient health record exchange in collaboration with Greenway. The expanding scope of Mercy Health’s health information sharing services has been a key factor in its success. Regarding challenges, the most significant issue currently facing Mercy Health is interoperability gaps among facilities; specifically, the electronic health record (EHR) systems provided by vendors for certain departments or organizations are incompatible with those used by Mercy Health. Mercy Health is actively engaging with relevant stakeholders to address this issue. Once the infrastructure is aligned, information connectivity across different points within these departments or organizations will become significantly simpler.
Looking ahead, rule-based actionable Clinical Decision Support (CDS) is the next initiative for Mercy Health. This approach can reduce repetitive tasks for clinicians and avoid unnecessary diagnostic and treatment steps. If Mercy Health can provide a consistently interactive framework, physicians at any point of care will have access to the information they need, regardless of where patients seek treatment.
Text | Zhang Fan
Editor: Mo Renying