QHN eNews Update 
October / November, 2013


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QHN Vitals - September, 2013
  • 803 Licensed Providers
  • 1,449 Active Users
  • 62,331 Virtual Health Record (VHR) Queries
  • 235 Clinical Data Bases 
  • 191,748 Lab Results
  • 37,806 Radiology Results
  • 85,741 Transcriptions Delivered
  • 18,541 Clinical Messages

QHN serves the western Colorado medical neighborhood. 

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Mesa County Physicians IPA


Western Colorado IPA

Mesa County Medical Society

Mt. Sopris Medical Society

Rocky Mountain Health Plans
Practice Transformation Team

Research Shows HIE Usage in ED Saves Time, Money and Improves Care

A new research study done at 11 emergency departments in South Carolina shows that having access to data in a health information exchange (HIE) improved the quality of emergency care and saved more than $1 million in patient charges.


The study was presented at the annual meeting of the American College of Emergency Physicians on October 14, 2013, in Seattle. "Nearly 90 percent of participants said that quality of patient care was improved, and 82 percent of participants said that valuable time was saved, reporting a mean time savings of 105 minutes per patient," according to study author Christine Carr, M.D., of the Medical University of South Carolina.


The research teams findings were based on a study of clinicians who cared for a sample of 532 patients who had information available in the HIE. Most of the cost savings were due to avoided radiology studies and hospital admissions.


Although we do not have hard research on the time and cost savings realized locally by the utilization of the HIE in the ED setting "off the cuff, the magnitude of savings is significant. I can't respond for all the ED providers at St. Mary's, but personally I use the VHR on almost every patient," noted Dr. Peter Dahlheimer, St. Mary's Hospital Emergency Department Physician. "The VHR is so powerful in understanding the medical background on the patient and in savings on duplicate testing."


"The rapidity of the data available in the HIE is truly amazing" continued Dr. Dahlheimer. "Just yesterday I had a patient that had been seen just one hour prior in Rifle and I was able to pull up the testing results from that visit upon his arrival at St. Mary's ED.   


When asked about the utilization of the HIE in the ED at Community Hospital, Dr. Marc Breen, Emergency Department Medical Director responded "having the QHN VHR repository is invaluable, the VHR gives us the full picture of the patient's health." Dr. Breen expanded the conversation to include the extensive usage of the HIE by other hospital based specialists, primarily the hospitalists, noting that when a patient is admitted from the ED, "they look at the ED physician's note and virtually simultaneously query the patient on QHN."


To view a sample of the savings noted in Dr. Carr's study, click here

After almost 30 years of availability, electronic health records (EHRs) are now at the forefront of clinical practice and healthcare policy. With a huge marketplace of over 500 systems and government incentives driving widespread implementation, the EHR adoption rate is at nearly 70 percent for primary care physicians.


However, meaningful use (MU) requirements and certification timelines are forcing many medical providers already using EHRs to reconsider their systems, implement upgrades and reassess their EHR needs. Having gone through the EHR implementation process once it can be daunting to consider an upgrade much less the transition to a completely new product. Unfortunately, some EHRs are incapable of meeting today's data sharing requirements and getting data out to participate in HIEs, or to meet the government's growing demand for data, can be a major obstacle in poorly designed EHRs.


As a REC participant and part of the Colorado Beacon Consortium (CBC), QHN has had the opportunity to work with hundreds of healthcare providers on their EHR implementation, MU attestations and the interface process to the QHN health information exchange (HIE). We have learned many lessons from the field and below are a few key things to consider in the upgrade process.


Lesson 1 - Identify and coordinate connectivity and interface requirements and timelines

Even if you are just upgrading your current EHR it is important to identify the requirements and notify those with whom you have connectivity or interfaces with, such as QHN and the Health Department, etc. This is important so a workable testing timeline can be established to minimize downtime once your upgrade is completed.Coordinate testing activities, requirements and timelines well in advance of your go-live date.


Lesson 2 - Plan for the workflow impact

All EHR changes have impact on workflow. Take the time with your EHR implementation team to map the workflow changes and identify the training needed prior to go-live. Many EHR upgrades are in response to today's data sharing,MU and quality reporting requirements. Discuss these new features with your EHR vendor and HIE account manager so you have a clear understanding of the data gathering, data sharing and data reporting capabilities.


Lesson 3 - Don't underestimate the importance and time required for training 

Especially with an upgrade it is easy to underestimate the amount of training required. Ensure that providers and staff receive full training, conducted in an environment free of distractions. Nothing is more frustrating to a provider than trying to see patients using an unfamiliar EHR environment. Do a full dress rehearsal prior to the upgrade and have dedicated real-time support during the go-live, this is when the learning potential is highest and staff training needs are the greatest.


If you have questions or need further information please contact your QHN Clinical Account Manager at: 970-248-0033. 

EMR or EHR Does it Make a Difference?

We frequently hear the terms electronic medical record (EMR) and electronic health record (EHR) used interchangeably. However the difference between the two terms is actually quite significant. The term EMR was adopted more than 30 years ago to describe the early electronic records, which were just "medical," confined to use within a specific practice. EMR basically refers to a digital version of a paper chart.


In contrast, by changing the word to "health" the term now encompasses a much broader definition to include the overall condition of someone's body and mind - a state of being well or free from disease. EHRs focus on the total health of the patient going far beyond the standard clinical data recorded in the confines of one provider's office. EHRs are designed to reach beyond the organization where the information originates and exchange information with other providers involved in the patient's care.


The EHR represents the ability to easily exchange medical information among care providers and to have a patient's information follow them through the various modalities of care. The information moves with the patient and when health information is shared in a secure way, it becomes a powerful tool to engage and support the patient's healthcare team.