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Will Future ED Physicians Actually Know Patients’ Medical Histories?

AKRON, OH –Imagine a future where, when a patient presents to your emergency department, you and other clinicians would have the complete medical history at your fingertips.

An emergency physician-led workgroup is trying to make that dream a reality. Published online by Annals of Emergency Medicine are five primary and seven secondary recommendations about how to maximize the value of health information exchange (HIE) in EDs.

"HIE helps emergency physicians – who usually do not have much information about their patients – access patient health information from multiple sources, which is essential for critical, time-sensitive decisions," co-author Jeffrey Nielson, MD, MS, of Summa Akron City Hospital in Akron, explained in an American College of Emergency Physicians press release. "The ultimate goal is a nationwide health information network that will allow physicians quick access to their patients' medical histories without compromising their privacy. It is a tall order for sure, but not an impossible one."

The study points out that a full longitudinal record more accurately reflects the way most patients obtain care: i.e., across multiple providers and provider organizations

The five primary recommendations are:

  • Emergency physicians must be involved in regional and federal HIE activities;
  • HIE policies must be based on best practices to promote liability protection related to HIE use;
  • Federal regulatory standards must prioritize data elements specific to emergency care and have emergency-specific user design;
  • Care standards and protocols for effective integration of HIE in emergency department electronic health records (EHRs) should be developed, including workflow optimizations and pushing of important HIE information to the clinician through flags in the EHR; and
  • Local professional groups should participate with HIEs to assure delivery of appropriate emergency data.

The seven secondary recommendations would significantly improve HIE for emergency physicians, although they are not focused specifically on emergency medicine, according to the workgroup.

"Significant changes are needed to support a system of effective national HIE that can rapidly and efficiently yield useful health information to health care providers in emergency departments," added co-author Jason Shapiro, MD, of the Icahn School of Medicine at Mount Sinai in New York. "These changes should include support for emergency physician access to all relevant patient information in properly summarized understandable form. The goal of all emergency physicians is to provide safe, efficient and effective emergency care, and more access to well organized patient information helps us achieve that goal."

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