EHRs Go Beyond Treatment

Posted by Mark Brousseau

An interesting article from Government Health IT on electronic health records:

EHRs go beyond treatment
Health IT promises to streamline agency requests for copies of clients’ medical records

BY Nancy Ferris Published on June 9, 2008

Americans are often asked to supply medical records when they enroll at a school, seek to obtain disability benefits or apply for certain jobs.

Having those records available electronically would make it easier for patients to access them, as long as there is a process in place for authorizing their release from various health care providers’ systems.

The Social Security Administration is leading a project to automate the process for obtaining authorized information from electronic health records. As officials struggle to deal with a growing workload of applications for disability benefits, they say they hope the initiative will make the agency’s job easier and improve service to the public.

SSA receives more than 2 million claims for disability benefits each year, a number that is expected to grow steadily. In each case, the agency obtains names and addresses of the applicant’s doctors and his or her authorization for the providers to release medical records to SSA. The agency then contacts the doctors and waits for the records to arrive by mail — a process that can take months and costs more than $500 million a year.

SSA officials say they envision being able to use the Nationwide Health Information Network (NHIN) to send authorizations to providers electronically and automatically receive the records in return. They are launching a pilot project that involves Beth Israel Deaconess Medical Center in Boston, and they are participating in trial implementations of the NHIN this year.

Not coincidentally, Dr. John Halamka, chairman of the Healthcare Information Technology Standards Panel and a prominent health IT advocate, is Beth Israel Deaconess Medical Center’s chief information officer.

As part of the project, officials will identify HITSP-approved standards that could be used in the process of obtaining medical records, said Debbie Somers, senior adviser at SSA’s Office of Disability Systems.

The agency’s officials know the standards will not completely meet their needs, Somers said, but they are determined to use them whenever possible. They are especially interested in adopting the Continuity of Care Document (CCD) standard, which summarizes the patient’s health conditions, medications and allergies.

At the same time, SSA officials will choose a standard format for electronic medical records used by disability examiners, who spend hours searching through files for specific pieces of information.

“With every hospital and doctor, the record is in a different order and it looks different,” Somers said. With CCD, examiners could pull data into SSA’s system. To make it even easier for them, the agency will highlight certain diagnoses and procedure codes that amount to evidence of disability.

“By the end of August or September, we will actually be requesting real data from [Beth Israel Deaconess] and receiving real live data back, which we can use to [fold] into the medical record,” Somers said.

For the NHIN trial implementations, SSA will work with other project participants to test the system’s ability to send requests and receive electronic medical records from the Military Health System, Veterans Health Administration, Indian Health Service and other providers.

“We hope to still have the same back end on our side but to be able to use the NHIN as a transport,” Somers said.

“It’s really amazing what these first steps are accomplishing,” she said, adding that SSA is on track to have a production infrastructure for retrieving EMRs in place next year.

As a result of the project, SSA could free millions of dollars, people with disabilities could get their benefits faster, and health care providers could be free of dealing manually with records requests from SSA. Halamka has said the resulting cost savings could pay for implementing the technology at hospitals.

Other providers of disability benefits, such as insurance companies, could also find the technology beneficial — along with schools, camps and other organizations that need copies of medical records.

“We may be the largest medical record requester, but we are only one,” Somers said. “People need to be able to provide the authorization and have their medical record go wherever it needs to go.”