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Critical Access Hospital Use Cases

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Transition of Care Longitudinal Record

Transition of Care Longitudinal Record

Health information exchange facilitates the seamless and effective handoff of clinical information between healthcare providers during care transitions. For example, a patient visits her primary care provider in Seldovia for a routine visit. The patient is referred by the PCP to a specialist in Homer for a consultation. The specialist diagnoses a condition requiring surgery. The patient is subsequently admitted to South Peninsula Hospital for surgery with the specialist. The patient then returns for follow up care by the PCP in Seldovia. In each of the care transitions mentioned, the HIE’s longitudinal care record improves the timeliness, accuracy, quality and completeness of patient data.

Provider to Provider Referral

The most common provider to provider referral occurs when a patient is referred to a specialist by a PCP. Today, when such a referral happens, it is difficult to forward clinical information from the PCP to the specialist and information may be exchanged with inadequate security using fax or regular mail. For example, assume a PCP in Kenai refers a patient to a specialist at Central Peninsula Hospital in Soldotna. When the patient returns to the PCP in Kenai, it is difficult to get the consultant report. The HIE solution provides built in capability to enable electronic referral of patient records from any provider to any other provider.
Provider to Provider Referral

Medication Record Look Up

Medication Record Look Up
Many providers wish they had more information about the types of medications their patients may have received from other care providers. Often the patient cannot provide current medications taken including medication names and doses. With access to the health information exchange providers can look up the patient’s medication history allowing for easier medication reconciliation. For example, a PCP at Samuel Simmons Hospital in Barrow could see medications prescribed to a patient seen at Fairbanks Memorial Hospital. This access to real-time medication history improves quality of care.

Emergency Department Coordination

Having additional information for a patient at the point of care can positively impact diagnosis, treatment, and outcomes. In addition, duplicative medical tests can be minimized. For example, a Wrangell resident is involved in an accident in Petersburg while attending the Little Norway Festival, and is immediately transported to the Petersburg Medical Center. The patient arrives unconscious to the emergency room and is unable to notify the providers of his current medications and allergies. With access to the HIE the emergency room providers could access the patient’s medication list and allergies to avoid any contradictions. The ability to rapidly access the medical record increases patient safety and improves emergency departments’ throughput.

Notifications

Notifications
Providers can set up notifications within the HIE to inform them if their patients have received care at other locations for laboratory tests, radiology, admission or discharge from a hospital, or an admission to an emergency room. A common scenario would be a PCP with the South Central Foundation could be notified immediately that one of her patients while visiting Sitka was admitted to the emergency room and had laboratory tests conducted at Mt. Edgecombe Hospital. This automated delivery of information allows for more efficient patient management and better coordinated care.

Advance Directives

The Advance Directives (e.g.: living will) use case enables provider point-of-care access via HIE. Authorized providers can query and view their patients’ documents helping to ensure patients’ wishes are considered when assessing therapy and treatment alternatives. For example, consider a scenario where a patient residing in Dillingham, AK creates an advanced directive and uploads it to AeHN’s patient portal. Months later he is admitted to Bristol Bay Area Health Corporation’s Kanakanak Hospital for chest pain. The attending physician accesses the Alaska HIE, and searches for available clinical information on this patient. A living will is discovered and viewed. This document is used to impact treatment and the decision to activate a Medevac with the BBAHC Air Ambulance.
Advance Directives

Public Health Reporting for Meeting Meaningful Use

Public Health Reporting for Meeting Meaningful Use
A Public Health Reporting use case takes the form of submitting applicable syndromic surveillance “chief complaints” from hospital emergency rooms through the Alaska HIE which are directed to DHSS via the Center for Disease Control’s BioSense public health surveillance system. For example, a severe outbreak of influenza may be anecdotally observed at the Norton Sound Regional Hospital in Nome and surrounding clinics. Rapid collection and exchange of this critical data from Nome through the HIE to DHSS supports early detection of outbreaks and situational awareness of the threat. With BioSense, critical data is exchanged faster, common awareness of health threats over time and across regional boundaries is improved, and investigations / community actions to protect health are supported.
All use cases are examples only and not intended to be interpreted as real experiences.