Mississippi’s Medicaid program is the first such agency to exchange summaries of patient care in real time with physicians in the state, kicking off a program to use the Epic electronic health record.

The program launched in early March. For now, real-time transmission of continuity of care records, known as the Consolidated-Clinical Document Architecture (C-CDA) patient summaries, are being sent to the University of Mississippi Medical Center EHR, but the state’s Medicaid program soon will roll it out to other health systems in the state using standardized terminologies, says John Showalter, MD, chief health information officer at UMMC.

Further, a portal is available to other physicians across the state to access Medicaid patient records, although the information won’t be sent to EHRs in real time.

John Showalter, MD
John Showalter, MD

The portal is available to other providers because the original idea, done in a soft launch in 2015, was to have UMMC physicians access Medicaid health information via the portal. However, the doctors didn’t want another information system that required registering with Medicaid and getting a new username and password, Showalter said.

Efforts to develop a new approach resulted in the decision to try to integrate Medicaid with the Epic EHR and deliver the information in physicians’ regular workflows.

Integration with Epic was straightforward, although vendor partner MedeAnalytics had to make some changes to its systems, Showalter says. “It took some time, but I don’t think it was impossibly challenging.”

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The project has been in the works for a couple of years. In 2014, data analytics vendor MedeAnalytics established a Medicaid Enterprise Master Patient Index and a single patient identifier, and also analyzed and de-duplicated medical records from 2.3 million Medicaid beneficiaries.

When the duplicates were removed, a longitudinal patient record was available for more than 750,000 Medicaid and Children’s Health Insurance Program beneficiaries.

As the information sharing initiative gains traction, MedeAnalytics expects to receive about 3,500 clinical inquires each day just from UMMC.

Showalter is excited at the potential for significantly improving the care of Medicaid patients by having more information available in the emergency and urgent care departments. However, the benefits won’t stop there, he believes; organizations using care coordinators will be able to better monitor patients to ensure that they are filling prescriptions and getting immunizations. Prescriptions also can be monitored for signs of narcotic abuse.

While many physicians still complain about the EHR meaningful use program, Showalter learned that there were good aspects of the program, which requires that interoperability and terminology standards be embedded in EHRs, which speeded the program’s ability to exchange information.

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