Case Study: Unified Patient Records from Multiple EMRs in One View

Multiple EMR challenges solved with next generation technology delivering full patient records in real-time. 


Managing patient data across multiple Electronic Medical Records (EMRs) is cumbersome, labor intensive and can greatly hinder patient care. Whether driven by mergers or value-based care, the need to collaborate with affiliates creates a key question for health systems: how to provide a clinician-friendly, consolidated view of patient records? When Tampa General Hospital (TGH) and USF Health (the University of South Florida faculty practice) decided to migrate USF Health from Allscripts to TGH’s Epic EMR, they turned to Sansoro Health. Sansoro’s Emissary solution gave USF Health users ready access to patient records from both EMRs.

Dr. Nishit Patel, M.D., chief medical information officer, USF Health believes patients notice and benefit. “Without this data, the patient might have questioned the competence of the provider or wondered why the provider didn’t know the last lab result,” says Patel. Adding, “now within Epic, providers use the embedded chart viewer to find PDFs of pathology reports, photos and progress notes − in real-time, during a patient visit.”

When assessing the medical record data that is needed to deliver quality patient care, most providers will quickly agree on the importance of medications, allergies, problem lists and recent lab results. But what about other information, including scanned images, social history and older lab results? These items may be infrequently referenced but critically important. Thus the dilemma: providing sufficient patient care may require access to almost any patient data. A clinician’s need for such information may be rare, but also time sensitive and live-saving.


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It is nearly impossible to accurately predict everything a provider might need to access in the future.
— Peter Chang, MD Chief Medical Information Officer, TGH.

When health care organizations move to retire an EMR, they face this same challenge; only made more complex by technical obstacles in converting legacy data. This data is vital for continuity of care and to meet regulatory requirements for maintaining health records. Most organizations find no easy way to migrate EMR data or view it in the old EMR. Lacking a strong technical solution, key stakeholders like clinicians, operations and IT find themselves wrestling with difficult tradeoffs.

Operational leaders like the CIO and CFO appreciate this clinical dilemma, but also must address the practical issues like cost, timelines, and resource limitations − not to mention accuracy of converted data. A substantial investment is required when converting from one EMR to another, with the cost largely driven by the amount and complexity of the data being moved. As only a limited amount of data can be converted in a migration, clinicians must log into another EMR − or request a paper record − when needing older data or a scanned image.

Clinical decision making suffers, duplicate testing and other inefficiencies drive costs higher, often resulting in unhappy clinicians and patients. Ultimately, patient outcomes will worsen because legacy data, like the chest x-ray scan or lab test, were not readily available.

In our case, specialty areas like dermatology had a lot of hand-written notes and scanned PDF reports. It is unrealistic to expect providers to spend time digging for all the information in multiple systems.
— Nishit Patel, MD Chief Medical Information Officer, USF Health.

The Solution
Sansoro’s Emissary solution leverages the power of Application Programming Interfaces (APIs) to make data from an external EMR conveniently available in real-time − at a fraction of the cost and effort of traditional approaches. In other industries, APIs support the real-time exchange of data across the modern digital economy. Sansoro brings this technology to EMR integration.

Making It Real at University of South Florida and Tampa General Hospital
USF Health includes over 500 faculty physicians with TGH serving as the primary teaching affiliate for the USF Health Morsani College of Medicine. When USF Health decided to stop actively using its Allscripts EMR and migrate to TGH’s Epic EMR, it faced typical EMR data conversion challenges: an inability to convert certain data types (e.g., images), resource and technology costs, errors in data after conversion and lengthy migration timelines. Recognizing the limitations of the traditional approaches, TGH and USF Health opted to implement Sansoro’s solution.

Dr. Patel, USF Health, explains that this partnership was a huge opportunity for USF Health and TGH to improve health outcomes. Patel says, “Primary care providers rely on having the full medical record available at their fingertips, so Emissary has had a significant impact on their patient care processes.”

This superior solution was delivered quickly. With no HL7 interface development required and the knowledge that legacy data would be readily available to clinicians, installation required minimal time from IT staff and yielding substantial cost savings. Additional savings will accrue over time including lower interface maintenance costs and a reduction in the number of legacy EMR licenses.

Dr. Chang, TGH, notes that the benefits extend to other members of the care team as well saying, “Ancillary and support staff utilization is key, as they often provide triage or welcome patients at organizational entry points.”

A clinician does not know from day-to-day what data will be required to provide optimal patient care. Since Emissary went live in December of 2015, clinicians at TGH and USF Health have a single, unified view of patient data to simplify workflows and provide
better care. Robust adoption of Emissary allows clinicians to view a broad spectrum of patient data including documents, encounters, labs, and problem lists – all in real-time. With only six maintenance or support calls since December 2015, the system has demonstrated high-reliability and low operating costs. Adoption continues to grow as clinicians use the system to retrieve a wide variety of information – testimony to the ongoing value of convenient access to patient data from an external EMR – with an API-based approach.

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