Two of NYC's largest and most renowned hospital systems have collaborated to produce a true breakthrough in EMR interchange! This is no joke: while at this early stage there are minor physical assists, the data being exchanged is fully electronic! This provides a model that can be replicated everywhere, even by systems that are less resource-rich than New York's finest.
Amazingly, I can't find any press releases or news stories about this game-changing break-through. But I know it's true and the systems are operational, because I've experienced it myself. My prior dissections of this issue here, here, here and here are now rendered obsolete. Read on for the details.
Background
As I've described before, I'm being treated for a kind of cancer at one of the world's best hospitals, Mt. Sinai. I'm getting excellent care and doing well. The doctor who is treating me specializes in my kind of rare disease.
I got a letter saying that my doctor was leaving Mt. Sinai. I found out that he's going to Northwell Health, another large, excellent health system in my area, and I decided to follow him there.
My task was simple: I was already scheduled at Mt. Sinai for an MRI to track my cancer's progress, and with my doctor to assess the results. Everything was covered by my insurance plan. All that had to happen was to shift the appointments and move my records.
That was when I discovered the amazing advances in EMR interchange between the hospitals, even with integration of insurance! I'm so excited about this, I'm tempted to give you all the details. But I'll just give the highlights.
Transferring the MRI appointment
I already had an appointment for an MRI at Mt. Sinai, as ordered by my doctor and pre-authorized by my insurance company. All I had to do was shift it over to Northwell. I can tell you from personal experience that making the shift was easy, because of the amazing electronic integration of the two systems. There were a couple minor bumps in the road, but hey, most everything is amazing. Some highlights of the process:
- I called Mt. Sinai. After a while, I found the person who told me I had to call Northwell.
- I traded phone calls with Northwell, and found that they needed a "script" (prescription) written by a doctor, and they couldn't access the one at Mt. Sinai.
- A couple more phone calls got me the script; only a couple!
- While most people at Northwell were unaware of it, there was a radiology center convenient to me, where, after spending well under a half hour on the phone, I was able to get an appointment!
- It turned out that the insurance pre-authorization couldn't be transferred. So during the course of just one morning, with multiple calls with me and a patient, helpful Northwell employee, I was able to re-get the pre-authorization! Let me stop here and show you this fabulous document I was able to get so quickly and with such little effort:
Approved. Yay!
But, nerd that I am, I did read on for "important information." Here's the most important part:
Well, maybe they won't pay it after all. And I won't know until it's too late. Oh, well, we'll hope for the best.
The highlight of transferring the MRI appointment
I've saved the best for last. The Northwell radiology people really wanted the doctor's prescription. I could understand that; if I were a radiologist, I'd want it too. The process was so modern, so electronic (with a couple minor physical steps), it's a real showcase of EMR interchange.
Here are the steps:
- After some real effort, someone at Mt. Sinai wrote a new prescription.
- They put the information into their electronic system, and arranged a UPS pickup. All they had to do was put the prescription in the envelope and get the right information on the cover.
- Fully computerized UPS picked it up and delivered it right to me. Pronto.
- All I had to do was scan in the prescription, and use a convenient SaaS service to send the digital image of the prescription via fully-electronic fax to the number Northwell wanted.
- When received at Northwell, all they had to do was enter the information into their modern, interchange-ready EMR system. Done!
Here is the transport mechanism. I have to show you, otherwise you may not believe me.
We're not done with the wonders.
I've had MRI's of this condition before. Naturally, the radiologists at Northwell wanted the prior scans, so they could see what had changed. All they needed was the images and reports from my prior scans. This was the real test of EMR interchange: could the Mt. Sinai system "talk" with the Northwell system and transfer the information? YES! IT COULD! Of course, this is leading-edge stuff, so there could be a couple minor improvements, but let's focus on the positive here.
Transferring the MRI and report
The process couldn't have been simpler. All I had to do was spend time on the phone with the Mt. Sinai people and before you know it, something arrived at my home. It was a package. If you look on the left of the package, you can see the evidence of a modern web interface having been used to create it:
Inside the package were two things. One was a modern, fully digital copy of my MRI, helpfully labelled.
The second was a direct output of a digital record, containing the analysis.
My job was simple: take them with me to the MRI appointment and hand them to the helpful people at the reception desk. Which I did, and they were happy to get them. In a flash, just a couple hours, the information was loaded into the modern Northwell EMR system. I could hardly believe it. Mostly-electronic transfer of fully electronic data from one EMR to the other!
The glitch in the process
I warned you there were a couple things that needed improvement. The radiologists at Northwell noticed that I had two prior MRI's, and Mt. Sinai had only sent one of them. Oops! Would I please get the other MRI? I guess it was hard for them to get it from Mt. Sinai themselves.
So I called. After a while on the phone, I made it to the records department. Apparently, it's kind of secret, because an upset person demanded to know who had given me her number! But in the end, she transferred me to a person who could help. It was easy -- all I had to do was fill out some forms and pay some money and they would take care of it right away.
The helpful records person gave me the search terms to put into Google to find the form on-line. It was just a couple pages long. Here's part of the beginning:
I guess the form should have had a third page, because he had me squeeze onto the second page the address where the MRI should be sent, and my credit card information to pay the roughly $30 it would cost. I printed it, filled it out, scanned it in and faxed it to him. The same day -- super-fast!
OK, it's a glitch. But I was impressed at how he was able to send the MRI straight to Northwell! Unlike the previous one, which I physically brought myself. Of course, I didn't pay for it, and this one I did, so I guess you get what you pay for...
Conclusion
It's just like I said at the beginning: two modern, innovative health systems are demonstrating how easy and convenient (nearly fully) electronic EMR interchange can be, and how much it improves things. If someone had told me, I would have been skeptical. I may even have resorted to sarcasm in my response. But none of that here -- I know by my own experience that it's true!
David, Brilliant as ever. I can only hope that such seamless, efficient, and error free processes come to healthcare in Boston soon. In all seriousness, I hope you continue to get good care despite all of these process nightmares.
All the best,
Carl
Posted by: Carl Byers | 10/18/2016 at 06:01 PM