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Secure Messaging and the EHR

December 29, 2011
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How the electronic health record is improving care at one major academic medical center

One of the impacts that electronic health records (EHRs) are having on the healthcare industry is the way clinical information is communicated, both among physicians and between physician and patient. Hospitals that have installed EHRs have a “secure messaging” platform that enables timely reporting of medical records as well as much improved care transitions.

I recently had an opportunity to speak with Timothy Burdick, M.D., a family medicine physician with Fletcher Allen Health Care, Burlington, Vt. Fletcher Allen has had an EHR (supplied by Epic Corp., Verona, Wis.), for about three years. In Dr. Burdick’s view, having an electronic record has paid off in better communication, both among caregivers and between physicians and patients.

One key area is improved care transitions. Fletcher Allen has an automatic messaging service that sends a notice to the primary care physician when a patient gets discharged; the service can also send a message to the patient’s extended care team, including specialists. All of the patient’s caregivers have almost instant access to the patient’s medication list, discharge summary, and past medical treatments. Before the service was available, Dr. Burdick said he would receive this information days after the patient’s discharge—sometimes after he saw the patient.

Physicians who are employed by the hospital but are not part of the medical staff also have full access to the EHR. In addition, physicians who are not employed by the hospital and not on staff have read-only access to the electronic record. (Fletcher Allen is the only tertiary-care academic medical center in Vermont, and doctors across the state often share patients. The read-only access has been extended to physicians across northern New York state, Massachusetts and New Hampshire.)

In addition, Fletcher Allen offers a patient portal, called MyHealth Online, which went live in June 2011. Dr. Burdick says most patients use it to securely view their medical information, medical history, current medication lists, allergies, and other personal health information. The hospital has been adding users gradually, but Dr. Burdick estimates it has about 10,000 users today.

One way the patient portal pays off: “Our medical records are not always accurate,” he says. Now patients who notice that their record needs to be updated—perhaps they see that a procedure to remove gallstones is missing—he or she can send a secure message to their physician.

These are just a few ways that electronic medical records are making possible more timely flow of information flow, more accuracy to medical records, and more fruitful conversations between doctor and patient.