As I have posted in the past, hospitals today come in various shapes and forms, so doing better financially than others and those who still have the ability are moving forward to work with physicians to extend the electronic medical record to the ambulatory setting (the doctor’s office) to where the records at the physician’s office and those at the hospital will interchange and exchange data, and this is also a big plus for the physicians with the hospital being able to defray some of the cost involved for the physicians too, due to a relaxing of the “Stark” provisions that are now allowing this to happen.
There are many ways in which this can be done, one is with a system installed at the hospital that will interchange and work with an ambulatory system and a second alternative, like the one mentioned here is an ambulatory system provided by Eclipsys, in other words a system all under one roof. Like always, there are pros and cons to both types of systems, as some solutions may be incorporating some open source software along the line, again, a combination in order to create a fluid working system to get the job done.
Basically what all this means, is software talking to software for the interchange and the ability of more physicians to embrace and use an EHR (electronic health record) to empower better documented healthcare. Along with the hospital and physician side of this comes the PHR (personal health record) which also needs to have some communication levels with both the hospital and the physician. I have written quite a bit on this blog about PHRs and a simple search here will bring up a lot of information and there are links to both Google Health and Microsoft HealthVault here all the time under resources.
PHRs will need to be linked as well, so as you can see this is a pretty massive project, no matter which way you look at it. It also somewhat calls for a tighter and heavily involved working situation with the ambulatory vendors with the systems installed at a hospital, be it McKesson, Cerner, Microsoft Amalga, Eclipsys to name a few as the major players in the hospital technology departments. No more is it sufficient to have a single standing operation in a physician’s practice that does not communicate with the outside world of healthcare. This theme was very much in discussion at this years HIMMS convention in Orlando with pretty much all vendors agreeing on such. 
Basically the call here is for everyone to get their software together to this can all come to fruition. From the personal healthcare side of things for a simple example, Microsoft has established vendor meetings and conventions and continues to work with vendors who will, with the ok of the patient, be able to populate the chart information for us. The PHR is somewhat in it’s infancy now, but will be a prime key element in the entire process, as with the information provided for us, as a consumer, this leaves very little effort on our part to add and change information, and we can update and correct information as we see fit though.
Get referred to another hospital and want to take some records and information with you, not a problem with the PHR, as long as you give the OK and the facility at the other end has some basic technology that will take the data transfer. Big problem here though is education and I find medical assistants, doctors, etc. that have no idea what a PHR is, thus perhaps time for a major education campaign as this is moving fast.
Again, good move on the part of this hospital and nice they are in a position to begin the transition however it occurs with their choices, but again this is one more calling to all software vendors to steady up those relationships and all work together. BD
The Community Hospital of the Monterey Peninsula will offer ambulatory electronic health records software to area physicians under relaxed provisions of the Stark Act and I.T. safe harbors to federal anti-kickback statutes. The Monterey, Calif.-based hospital will offer the Sunrise Ambulatory Care EHR from Eclipsys Corp., Atlanta. The hospital in 2002 implemented Eclipsys' Sunrise Clinical Manager suite of clinical software and Sunrise Patient Financials applications. Now, the hospital plans to integrate physicians' outpatient records with its inpatient records, providing all caregivers with an enterprise EHR, as well as clinical decision support.
Hospital to Subsidize Doctors' EHRs
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