Children’s Hospital of Philadelphia (CHOP) and Virtua, a southern New Jersey health system, have unified their radiology operations across electronic health records systems and state lines.
By deeply integrating imaging systems and EHRs, the two systems have made it possible to create an integrated health record that includes images captured at a Virtua facility and read by pediatric diagnostic imaging specialists at CHOP.
“One of our guiding principles for the partnership was that when the patient family needs radiology services, they could be done either at CHOP or done at Virtua,” says Gayle Stidsen-Smith, the CHOP IT director who oversees support for its picture archiving system and served as CHOP’s project lead. “We wanted to make it so New Jersey patients could have images done in their own backyard. Those images would reside in both the Virtua electronic medical record as well as the CHOP medical record, even though they’re completely different systems with different database structures.”
Although health information exchange (HIE) technologies are important to many of the federal government’s initiatives to promote better coordinated care based on digital patient records, the records exchanged often are treated as supplemental information, appended to, rather than integrated with, the patient record. Moreover, radiology image sharing typically is outside the scope of services HIEs provide. Last week, Nuance announced a diagnostic image sharing cloud service that integrates with Nuance software for automatically transcribing radiology reports. Nuance promised deeper EHR integration to follow.
Virtua’s project lead, director of integration Julia Staas, says her organization is an active participant in building the New Jersey Health Information Network community HIE, but she agrees the CHOP partnership represents a deeper level of integration than most healthcare organizations have achieved between institutions. More typically, HIEs aggregate information and make it available to view with a portal. Routing of information such as lab results is another popular application, which is sometimes more deeply integrated with EHRs.
“What hasn’t been done much is sharing care across organizations,” says Staas. “If for some reason the child needed to be transferred to CHOP, because of this partnership we’re not re-imaging the patient — so we’re not including the radiation exposure.”
CHOP and Virtua went further by creating an integrated business process, where records of patients registered as part of the diagnostic imaging partnership are matched between the two EHRs, if possible. If no record for a given child exists in CHOP’s Epic EHR, a new record is created containing a reference to the patient identification number from Virtua. This record key makes it possible to keep patient records synchronized between the two EHRs going forward. For additional information, visit www.virtua.org
