Information Technology Reference
In-Depth Information
The platform is optimized to build a longitudinal patient record by integrating
with clinical inpatient systems such as the billing system, the emergency depart-
ment system, the inpatient EHR, the laboratory system, the radiology system, and
the transcription system via HL7 and CCD standards. Ambulatory EHRs can use
either the CCD format or HL7 to integrate with RelayHealth. For coordination of
care, support for DIRECT is planned by year-end 2012. The company also has plans
to support the new Transitions of Care (TOC) Consolidated CDA format, a version
of the CCD with contents designed for situations where patients move from one
care venue to another. An example would be discharge from a hospital to a rehabili-
tation facility after surgery.
The end result is that patients get an integrated inpatient/outpatient longitudinal
patient record as well as tools to manage their care. They can also get a total family
record -- parents and children's health records in one place. Patients can contribute
most of their data but RelayHealth does not yet support uploads from devices such
as glucometers or digital scales.
Appointment requests can be made through the portal. These requests are routed
to the staff members within a practice that are trained to interface with the
RelayHealth portal in order to receive them. Patients can also request prescription
renewals and refills through the system. All such transactions are routed to pharma-
cies through SureScripts, the nationwide network that interconnects them. [
8
] ePre-
scribing is a key Meaningful Use requirement so this can be an important feature for
provider practices.
The system provides patient-to-provider and provider-to-provider secure mes-
saging as well as management of sending orders and receiving their results. The
patient's primary care physician gets automatic notification of any emergency
department visits, an important feature to help assure continuity of care.
To support all this functionality RelayHealth provides a cross organizational
master patient index (XMPI) and does extensive terminology mapping to and from
its base nomenclature of SNOMED for clinical problems, ICD-9 for diagnoses and
Medi-Span
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for medications.
Personal Health Records (PHR):
While the Internet and mobile devices have made
patient journaling of health information far more feasible, this, like most other
“innovations” in health informatics, is not a new idea. At least one 1978 paper is
commonly cited in a discussion of the history of the concept. [
9
] Today, PHRs are
an active topic of discussion, research and development. [
10
] [
11
]
A PHR is a patient-maintained record of health and health related information.
Decades ago, before home glucometry was technically and economically feasible,
physicians might ask their diabetic patients to maintain a journal of their urine glu-
cose measurements taken using a colometric chemical strip test. The concept of
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MediSpan is one of the commercial providers of extensive medication databases. Other provid-
ers include FirstDataBank, Micromedex, Gold Standard, and Multum.
