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UC Davis Health System

UC Davis Health System

UC Davis, Sutter first in region to share electronic health records

Ambulance delivering person to emergency room © UC Regents
Click to view video about Care Everywhere 

Posted Feb. 9, 2011

When Tina Palomino awoke at 1 a.m. on New Year's Day in a pool of blood, she headed straight to UC Davis Medical Center's emergency department. There, physicians obtained blood tests and an ultrasound and treated Palomino's condition, caused by uterine fibroids, and used a new, secure Internet connection with Sutter Health to review her electronic health record. Having access to her previous office visits, including laboratory and ultrasound reports and her history of an allergic reaction to a common fibroid medication, enabled UC Davis emergency medicine physicians to quickly develop a care plan and discharge her within a few hours. And when Palomino receives follow-up care with a specialist, the details of her emergency department visit will be available to further inform her care.

The cutting-edge record-sharing partnership between UC Davis and Sutter is the first among health systems in the Sacramento region and among the first wave of connections between health-care institutions in the state. Record sharing ensures that crucial patient data gets to physicians at the time they are delivering patient care, saving time and potentially reducing costs.

"The ability to access electronic health records for patients who need to receive treatment from physicians who are not their regular providers is invaluable," said Douglas Kirk, professor and vice chair of emergency medicine at UC Davis Medical Center. "Sharing electronic health records across institutions saves time, decreases the need for repeat medical testing and gives caregivers access to important clinical information, often eliminating the need to transfer records by phone or fax."

Made possible through new software functionality added to the Epic Care Electronic Health Record used at both UC Davis Health System and Sutter Health, the connection gives physicians delivering care within the Sutter Medical Group and anywhere within UC Davis Health System instant access to a patient's electronic health record with the patient's consent.

Dr. Doug Kirk © UC Regents“The ability to access electronic health records for patients who need to receive treatment from physicians who are not their regular providers is invaluable.”
— Douglas Kirk

Steven Hedrick, deputy director of rehabilitative programs at the California Department of Corrections, was relaxing at home when he began experiencing such severe pain in his lower abdomen that he drove himself to the nearest treatment center — Sutter North Urgent Care in Yuba City. Physicians there obtained a CT scan to diagnose a kidney stone and prescribed pain medication. When he returned to see his primary-care physician at UC Davis, the results of his laboratory studies and radiology reports done at Sutter Health were immediately available. The records enabled his doctor to understand the situation quickly and continue monitoring the kidney stone with a complementary ultrasound test, which identified other issues with his kidney that needed additional workup.

"Without reviewing the data from Sutter promptly, there would have been a delay in proper treatment, which could have led to continued pain and possible kidney damage," said Scott MacDonald, an internist with the UC Davis Medical Group in Sacramento and Hedrick's primary care provider.

Sharing electronic health records gives treating physicians access to comprehensive patient data, including the patient's medical history, family medical history, previous diagnoses, medications, allergies, physician's notes and results of radiology, laboratory and medical procedures. Since the program launched in December, UC Davis and Sutter have exchanged more than 350 patient records, and efforts are under way to broaden the number of hospitals locally and throughout the state that share electronic health records. To date, three other care providers in California — Memorial Care Health System, Talbert Medical Group and Rady Children's Hospital in Southern California — are currently exchanging electronic health records using the Epic functionality.

Nurse and doctor review medical record © UC RegentsUC Davis Health System is at the forefront of health-care providers nationwide that are exchanging health data to improve patient care.

Over the past few years, UC Davis Health System has transitioned from paper records to a fully electronic clinical information system that includes digital clinical results and images, computerized physician order entry, sophisticated pharmacy systems and online documentation and care plans.

For its sophisticated array of digital content and functionality at UC Davis Medical Center, HIMSS Analytics recognized UC Davis Health System with its EMR Adoption Model Stage 6 Award.

HIMSS Analytics, which is part of the nonprofit Healthcare Information Management and Systems Society, tracks 5,235 hospitals in America, and the medical center is the 164th hospital in the country to earn level 6 designation.

UC Davis and Sutter are among the 16 health-care organizations in California using the same platform — Care Everywhere — for their clinical information system, which should allow the exchange of electronic health records to progress quickly. These include Kaiser Permanente, UC San Diego, UCLA, UC San Francisco, Stanford Hospital and Clinics, Cedars Sinai Medical Center, Community Medical Center in Fresno, Riverside Medical Clinic, Sansum Clinic in Santa Barbara, Providence Health & Services, and Oregon Community Health Information Network (OCHIN), an Oregon-based medical group supporting eight Federal Qualified Health Centers in California. Other care providers who don't use Care Everywhere can utilize industry standard-based interfaces to exchange clinical data, but the Epic-to-Epic sharing functionality exceeds the content shared with these standards, such as the Continuity of Care Document (CCD).

"The ability of clinicians practicing at different health-care institutions to share electronic health records is at the forefront of national initiatives to improve health care," said Michael Minear, chief information officer at UC Davis Health System.  "When we share patient data with other hospitals and physicians using secure and easy-to-use health information exchange technologies, we support better health care, provide convenience for our patients and create the potential to reduce the cost of care by avoiding duplicate testing."

A goal of the American Recovery and Reinvestment Act and the Health Information Technology for Economic and Clinical Health (HITECH) Act is to computerize the nation's health records by 2014. Medicare and Medicaid have established payment incentives, and federal reimbursements to hospitals and physicians that deploy and use electronic health records are designed to foster the development of a robust information technology health infrastructure nationwide.

To establish the exchange of health records between UC Davis Health System and Sutter Medical Group offices, a multidisciplinary team composed of informatics, technology, physician, nurse, legal, compliance and health-information management experts collaborated for more than a year.  With this functionality now in place, a key goal is to broaden the number of hospitals and care providers that can share clinical data.