Upham’s Corner Health Center is dedicated to providing comprehensive and personalized care to all patients. Their goal is to offer each patient continuous primary care in comfort and convenience. The health center is committed to delivering high quality, low cost, culturally sensitive, community-based health and social services to the community.
Challenge
Upham’s Corner Health Center (UCHC) identified a bottleneck in services when sending referrals from the primary care providers to Boston Children’s Hospital (BCH) and other health systems outside its primary referral hospital. The process was slow and drawn out, due to the need to rely on paper and fax machines. This hindered the quality of care UCHC was able to provide its patients, as well as added additional steps for providers and increased the likelihood of mistakes and lost reports and referrals.
Solution
Using the HIway for electronic health information exchange
In late 2017, UCHC implemented a project to begin using the Mass HIway to securely communicate and exchange information with facilities that have different Electronic Health Record (EHR) systems.
UCHC’s intent was to exchange medical records electronically via a new communication workflows. The goals of the project were to ensure that:
- Patients have made specialist appointments as needed
- Patients are keeping their specialist appointments
- Specialist reports are being received and saved in the patients’ charts
UCHC implemented the new workflows to reduce the likelihood of lost reports, and reduce the need to rely on fax machines. This would also enable them to have a dedicated staff member to follow up on overdue reports, and to improve care coordination by allowing providers to review any notes prior to patient visits.
Implementation and Testing
During the initial implementation phase, UCHC tested how documents came in from BCH to assess how best to upload them into their Electronic Health Record (EHR) system, OCHIN Epic EHR. Once they tested the process and determined the most efficient methods, UCHC developed the workflow to establish a regular method for uploading information into the EHR.
Moving forward, UCHC implemented enhanced Medical Records Department workflows using the Mass HIway’s webmail system. The bi-directional workflows allow for secure information to be sent between UCHC and BCH.
UCHC tested the new workflows with its pediatric team. Using this smaller pilot testing group allowed for greater control and the ability to change and alter workflows to determine best practices for potential roll-out across other departments.
While BCH actively participated in this project, there was limited impact on their workflows, as the hospital already used the HIway to communicate with other hospitals and health centers.
Support from MeHI
UCHC funded this project through a Connected Communities grant. The center worked with MeHI, the Massachusetts eHealth Institute at MassTech, to engage the Mass HIway and BCH. The Connected Communities Program promotes collaboration and adoption of Health IT to improve patient care and reduce healthcare costs.
Impact
When UCHC implemented this program, they set process improvement targets. During the measurement period between November 1, 2017-January 31, 2018, UCHC intended for 40% of referrals sent to BCH to be followed by a clinical note back to UCHC through the Mass HIway. UCHC exceeded this measurement, as 53% of referrals resulted in a note sent back to UCHC via the HIway.
UCHC also set goals for follow up appointments to be kept after calls to patients by UCHC staff using the new webmail system. In this measurement, UCHC came close to its goal, reaching 53% of patients keeping their follow-up appointment, out of a targeted 60%.
Next Steps
By promoting the success of piloting the new HIE-based workflows with its pediatric team, UCHC hopes to advance further adoption by additional departments in the future.
For more information about Upham’s Corner Health Center, visit http://uphamscornerhealthcenter.org/.