HIE Critical to Emergency Medicine, But Info Lacking in ERs

Care standards and protocols to support data exchange in emergency department electronic health records need to be developed, including workflow optimizations and pushing of important information to the clinician through “flags” in the EHR.

Those are among the recommendations from an emergency physician-led workgroup on how to maximize the value of health information exchange in emergency departments. The five primary and seven secondary recommendations were published online recently in Annals of Emergency Medicine.

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“Significant changes are needed to support a system of effective national HIE that can rapidly and efficiently yield useful health information to health care providers in emergency departments,” said co-author Jason Shapiro, M.D., of the Icahn School of Medicine at Mount Sinai in New York, N.Y. “These changes should include support for emergency physician access to all relevant patient information in a properly summarized and understandable form. The goal of all emergency physicians is to provide safe, efficient and effective emergency care, and more access to well organized patient information helps us achieve that goal.”

But, according to the workgroup, given the fact that patients receive care in multiple locations complete records of their health information are often not available at the point of care, which is a major challenge for emergency departments and physicians who must make critical, time-sensitive decisions with a paucity of information.

“HIE helps emergency physicians—who usually do not have much information about their patients—access patient health information from multiple sources, which is essential for critical, time-sensitive decisions,” said co-author Jeffrey Nielson, M.D., of Summa Akron City Hospital in Akron, Ohio. “The ultimate goal is a nationwide health information network that will allow physicians quick access to their patients' medical histories without compromising their privacy. It is a tall order for sure, but not an impossible one.”

Towards that end, the workgroup recommends that emergency physicians must be involved in regional and federal HIE activities and that federal regulatory standards must prioritize data elements specific to emergency care and have emergency-specific user design. Also, local professional groups should participate with HIEs to assure delivery of appropriate emergency data and consider conducting pilot programs with HIEs to improve the focus on emergency care.