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Creating a Health Information Exchange Application to Provide Fast Access to Patient Data in Emergency Department Settings

Creating a Health Information Exchange Application to Provide Fast Access to Patient Data in Emergency Department Settings

Integrating health information exchange (HIE) data directly into electronic health records has the potential to improve delivery of care and patient outcomes, as well as increase clinician satisfaction by providing efficient access to HIE data.

Finding the right information for timely care

Before the digitization of medical records, data in a patient’s record were tied to the institution where the patient received care, which made sharing the patient’s health data between different healthcare institutions difficult and time consuming. With the explosion of digital healthcare technologies in the last few decades, in theory, people’s health information is more shareable, and therefore accessible. But sometimes the data needed to make critical decisions in urgent care settings are difficult to find. This research is creating a tool so that providers have the important information about a patient’s health history, especially in the emergency department (ED) setting, where life and death decisions need to be made quickly.

In an emergency, time matters

Patient health data are often stored across multiple healthcare systems. A key step to improving healthcare during an acute incident is being able to access information about a patient that may not be documented in their ED medical record. Integrating these data with the clinician’s electronic health record (EHR) has the potential to decrease repeated or unnecessary diagnostic tests and to expedite care and treatment in potentially life or death situations. Currently, HIE functionality is often burdensome to access from a provider standpoint, requiring external navigation outside the ED’s EHR system. This disruption of clinical workflow to access HIE data is not conducive to a provider who needs fast and easy access to a patient’s medical data. Directly and seamlessly integrating HIE data into the ED’s EHR should facilitate data access and use by providers, giving them quick access to relevant data to inform clinical decision making.

ED physicians usually don't have much time to make decisions, and there is a sense of urgency to the patient's problems. You really can't spend minutes looking up stuff on the computer when somebody is bleeding to death right next to you. How do we get the most relevant information for the patient in front of emergency medicine providers?”
- Dr. Schleyer

Timely access to medical information in the ED

To address this challenge, Dr. Titus Schleyer and his team at Indiana University-Purdue University at Indianapolis are developing and evaluating a novel application called Health Dart that will be implemented and tested in 14 EDs. This application will seamlessly integrate highly relevant information from the HIE directly with the EHR in the ED. The Health Dart application uses the HL7 Fast Healthcare Interoperability Resources (FHIR®) standard, which allowed the researchers to develop an application that retrieves data from the HIE and displays it in the ED’s EHR, essentially weaving the HIE and EHR environments together. The use of this application has strong potential to improve care. The initial development of Health Dart occurred in a simulated environment where the researchers compared the traditional method of retrieving information from the HIE through a separate (i.e., outside the EHR) web portal to using Health Dart. A provider’s search time of relevant information decreased from about 4 minutes to 10 seconds with the number of clicks reduced from 50 to 6. In an emergency, every minute matters, and the researchers believe that this study will show the Health Dart application can improve ED care delivery, patient outcomes, as well as provider efficiency, satisfaction, and HIE use.