The Stage 2 meaningful use summary-of-care objective reportedly has been a challenge for eligible providers, particularly measure 2, which specifies that more than 10 percent of transitions or referrals must be electronically transmitted using certified EHR technology to a recipient. However, it’s not an insurmountable obstacle, according to one North Carolina group practice that is using new technology to facilitate EHR integration with referrals.
Raleigh Medical Group (RMG) is a 29-provider internal medicine and gastroenterology group with four main and 11 satellite locations in the Research Triangle area of the state. “It was meaningful use that precipitated a requirement for us that on our summary-of-care referral order, 10 percent of the time we had to Direct message electronically to the referral,” explained Kelly Crisp, director of health information and technology at RMG. “We had added that capability earlier in our EHR [Allscripts Pro] in preparation for meaningful use. However, out in the community, it was very challenging to find folks who were also utilizing that technology so that we could use the function.”
RMG participates in a Medicare Shared Savings accountable care organization, WakeMed Key Community Care (WKCC), which has been working on interoperability challenges among its practices for several years. Part of the solution is the Intelligent Care Coordinator (ICC) referral system developed by Infina Connect of Cary, N.C.
“We’ve incorporated EHR interoperability through CCD exchange using Direct messaging as a mechanism for moving data in and out of the EHR,” said Infina Connect CEO Mark Hefner. “We’ve got the ability — even for providers without an EHR — for participants in the network to accept and review clinical information. Specialists have been providing their visit summaries back to the primary care provider so that primary care has a complete record of what happened to their patient downstream.”
Hefner said the company has integrated with over 40 different EHRs in this fashion. “All they need to be able to do is generate a Direct message out of the EHR, which is a built-in capability for all certified EHRs, and then point it to a Direct address, which is basically their in-box in our platform. That allows them to push clinical information over. We actually extract the information, populate a pending referral and deliver it on the other end to the recipient so they have access to the electronic document.”
“Our involvement with the ACO through WKCC has been important as kind of a segue into us being able to utilize this technology,” Crisp shared with HealthITInteroperabilty.
Sujatha Raman, MD, an internal medicine physician with RMG, added, “In working with an ACO, the biggest advantage is inter-communication and trying to figure out where the patients are, what has been done for them and what needs to be done — and to have that communication effectively. [This technology] has tremendously enhanced our interpersonal relationships with the specialists because it gives us timely access to information and we’re not repeating tests.”
Crisp noted that the referral system will enable RMG to satisfy the meaningful use requirement for 10 percent electronic transmission in 2015. “For 2016, we will have to satisfy 10 percent of all referrals for the whole year. Obviously it’s going to be a crucial part of our workflow,” she commented.
Hefner expects further efforts within the ACO to improve clinical outcomes through better coordination of care. “It is a tribute to the larger group, including RMG, in taking this on and becoming very successful in managing patient populations. We’re beginning to learn from them around the key workflows that they require,” he concluded.
