CASE STUDY: SOLVING THE EMR INTEGRATION CHALLENGE

How Tampa General Hospital Moved from Multiple EMRs to Unified Patient Records 

 
 
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. 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.
— Nishit Patel, M.D., Chief Medical Information Officer, USF Health

Tampa General Hospital

OVERVIEW

Tampa General Hospital (TGH) is a private not-for-profit hospital and one of the most comprehensive medical facilities in Florida with 1,011 licensed beds and nearly 7,000 employees. TGH serves more than four million area residents in Tampa and 23 surrounding counties. The hospital is the area’s only Level I trauma center and one of just three burn centers in Florida. TGH is home to one of the leading organ transplant centers in the country, having performed more than 6,000 adult solid organ transplants. In addition, the organization is a nationally certified comprehensive stroke center. TGH is the primary teaching hospital for the USF Health Morsani College of Medicine.


THE CHALLENGE: MULTIPLE EMRs, ONE VIEW OF PATIENT DATA

Managing patient data across multiple Electronic Medical Records (EMRs) is cumbersome, labor intensive and typically slows the path to providing quality patient care. Of course, patient data is vital for continuity of care. And yet when a health care system retires its EMR system, the process of migrating legacy data to the new one becomes complex. Many organizations simply choose to maintain data in multiple EMRs, forcing clinicians to log into two or more platforms — or worse, placing requests for paper records — as they strive to deliver quality care.

While health care providers agree that complete, high-quality patient data is a must, odds are that legacy patient data will be lost as it is converted to a new EMR. Difficult tradeoffs are often made when prioritizing data to migrate into the new EMR. Most agree that basic data like medications, allergies, problem lists and recent lab results must be transferred, however other elements that influence care — such as scanned images, social history and lab results — are frequently left behind. A clinician’s need for such information may be rare, but also time-sensitive and life-saving.

Operational leaders like the CIO and CFO appreciate this clinical dilemma, but are also sensitive to issues like cost, timelines and resource limitations — not to mention accuracy of converted data.

When clinical decision making suffers, resulting in unhappy clinicians and patients, or costs increase because of duplicate testing and other inefficiencies, these senior leaders may begin to seek out answers and a solution that ultimately benefits everyone.

Viewing Patient Records

Health systems that grow through mergers and acquisitions, or by changing operational philosophies to focus on value-based care, must collaborate with their health care partners and affiliates. The demand for collaboration to ensure the best possible patient outcomes raises a troubling question: how to provide a clinician-friendly, consolidated view of patient records?

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
 

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HOW SANSORO HEALTH SOLVED TAMPA GENERAL’S INTEGRATION CHALLENGE

When Tampa General Hospital and USF Health (the University of South Florida faculty practice) decided to migrate USF Health from Allscripts to TGH’s Epic EMR, they wanted to ensure that EMR users from both facilities had ready access to patient records from both platforms. The organization knew it would face EMR data conversion challenges including:

  • An inability to convert certain data types (e.g., images)
  • Resource and technology cost constraints
  • Errors in data after conversion
  • Lengthy migration timelines.

Recognizing the limitations of the traditional approaches, TGH and USF Health leaders turned to Sansoro Health for expertise to ensure clinicians and staff retained access to complete patient records across the two systems from a single portal.

As many industries have discovered, Application Programming Interfaces (APIs) easily support the secure, real-time exchange of data across digital platforms. Sansoro Health designed its Emissary solution for health care using the power of APIs to integrate data from multiple EMRs available in real-time. Emissary solves the EMR integration problem at a fraction of the cost and effort of traditional manual approaches.

For TGH and USF Health, Sansoro Health combined Emissary APIs with an embedded chart viewer to deliver real-time, searchable patient record views and an ability to browse legacy data from within the new EMR. And by using the proven Emissary API to accomplish this integration, the health system’s IT staff can free up time and devote it to other critical tasks.

SANSORO HEALTH’S SOLUTION

  • Emissary APIs integrate multiple EMRs with less labor and expense than traditional approaches
  • Clinicians and staff now have access to full patient records in real time
  • Complete patient records enable TGH and USF Health to deliver high-quality care

RESULTS

Sansoro Health API Calls

The Sansoro Health Emissary solution was delivered quickly for TGH and USF Health. With no Health Level 7 (HL7) interface development required, and the knowledge that legacy data would be readily available to clinicians, the Emissary API required minimal time from IT staff. In addition, Emissary began providing TGH and USF Health with substantial time and cost savings. Over time, the solution will provide lower interface maintenance costs and a reduction in the number of legacy EMR licenses needed by the health system.

Dr. Peter Chang, M.D. and chief medical information officer, TGH, said the benefits of Emissary extends to other members of the care team as well. “Ancillary and support staff utilization is key, as they often provide triage or welcome patients at organizational entry points.”

With Emissary, clinicians have access to all medical record data. This has proven to be critical, as clinicians are accessing a diverse spectrum of patient data fields and cannot predict which data will be required to provide optimal patient care on a day-to-day basis. Since Emissary was deployed in December 2015, clinicians at both TGH and USF Health have benefitted from a single, unified view of patient data to simplify workflows and provide better care.

Adoption of Emissary continues to grow, allowing 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, Emissary has demonstrated high-reliability and low operating costs.

Most importantly, according to Dr. Patel, the collaboration with Sansoro Health has enabled USF Health and TGH to improve patient health outcomes. “Primary care providers rely on having the full medical record available at their fingertips,” said Patel. “Emissary has had a significant impact on their patient care processes.”

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