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Exploring data exchange in UPMC’s pediatric environment

At a recent meeting for clients that use Allscripts population health solutions, we heard several success stories. Despite various outstanding achievements, many interoperability conversations started with, “We’re not as far along as UPMC, but…”

A clear leader in interoperability, UPMC is a healthcare provider and insurer. To give a sense of the organization’s size and influence, UPMC operates more than 20 hospitals and 500 outpatient sites.

At the meeting, clients heard from two Assistant Professors of Pediatrics in the UPMC Division of Newborn Medicine, Sean Frederick, M.D., Assistant CMIO at Children’s Hospital of Pittsburgh of UPMC and Amy Urban, DO, Clinical Director of Interoperability at UPMC. They shared an interoperability journey in a pediatric environment at two busy tertiary care facilities, Children’s Hospital of Pittsburgh of UPMC and Magee-Womens Hospital of UPMC.

Data exchange in a pediatric environment

It’s an electronic world at UPMC, with widespread use of electronic health records (EHRs). Children’s Hospital of Pittsburgh of UPMC is the only pediatric facility in Pennsylvania to be recognized as a HIMSS EMRAM Stage 7 hospital and is renowned for its all-digital campus.

Drs. Frederick and Urban talked about the importance of exchanging information, especially in a pediatric environment:

Intra-hospital exchange. Communication starts within the hospital. Continuity of obstetric care is important – from prenatal care, through labor and delivery, and finally through post-natal care. UPMC’s Magee-Womens Hospital has a different vendor for its inpatient and outpatient systems, but it must seamlessly review and exchange data between the two systems.

Intra-facility exchange and transfer. For situations such as high-risk neonatal births, or special surgical and subspecialty evaluation of infants, it’s important for UPMC’s facilities to be able to share information. Children’s Hospital of Pittsburgh of UPMC and Magee-Womens Hospital of UPMC use the same vendor for their inpatient systems, but those systems are set up in different environments. When babies move between facilities, their complete medical records must follow.

Inter-institutional exchange and transfer. As the leading provider in the Pittsburgh area, UPMC hospitals often receive patients from surrounding community hospitals and from urgent care clinics to UPMC emergency departments and inpatient units for further evaluation and care. It’s critically important to be able to connect with statewide sources of information, such as health information exchanges (HIEs), to review pertinent medical information.

Using dbMotion for regional information exchange

The Pennsylvania Statewide Immunization Information System (PA SIIS) receives immunization messages and information from all healthcare organizations throughout Pennsylvania. UPMC entities can access this information through the web-based dbMotion environment or within their native EHR environments.

“Using dbMotion we can review a complete immunization history for each child from PA SIIS, ensuring that each child is up to date on all recommended immunizations,” Dr. Urban said.

Another UPMC-supported effort to connect broader community data is ClinicalConnect Health Information Exchange (CCHIE), the largest HIE in the state of Pennsylvania with more than 7.3 million unique patient records.

Some of UPMC’s outpatient pediatric facilities went live in 2013 and have started using the data. For example, a pediatric rehabilitation facility has 194 active clinical users who have viewed 9,300 patient records and have contributed 11,600 documents to CCHIE. One of the largest independent pediatric physician practices in western Pennsylvania also went live viewing data in 2013, and it has 160 active clinical users who have viewed more than 2,400 patient records.

Studies have shown that access to comprehensive patient information can help clinicians make better decisions at the point of care. “dbMotion fills in the blanks,” Dr. Frederick said. “It works seamlessly within our existing workflows and electronic environments…some physicians probably don’t realize it’s a different solution providing the information.”

Part of a broader vision for patient-centric care

Drs. Frederick and Urban emphasized that the true goal of interoperability is to provide more patient-centric care.

“It’s all about meaningful contextual information at the point of care,” Dr. Urban said. “The right information, to the right stakeholder, in the right format, through the right channel, at the right point in the workflow.”

Editor’s Note: In 2013 UPMC sold its interest in dbMotion to Allscripts. UPMC partnered directly with dbMotion for seven years on an interoperability solution that seamlessly brings together patient data across the health system to improve the delivery of care.

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