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* In Tennessee, the
* In New York,
All of these information swaps, and several others now in pilot phases, are propelled by the
Using Direct Project protocols, providers could send clinical messages to one another, regardless of their location or institutional affiliation, without relying on fax machines and sneakernet (i.e., courier service). The information contained in the messages could, when appropriate and correctly formatted, slide directly into an electronic health record, a database, or any other digital receptacle without scanning or transcription.
"We've been toying with this for awhile, but we've been so busy getting EHRs to be something that's clinically usable," Hickman says. "For this to be meaningful, you have to have a critical mass of EHR users in a community. We have that critical mass and [Direct messaging] will be the next thing."
In Hickman's mind, the Albany pilot shows how seamlessly and inexpensively Direct messaging should work if it's executed correctly. "The vendors are the ones who have made the notable investment, because they had to make software changes," he says. "The investment we've made is one we had planned to make already, and it wasn't substantial. It's been mostly just smart people getting together, and doctors showing us what's clinically meaningful to them."
Four EHR vendors are participating-Allscripts, Epic, Greenway, and
The system automatically gathers the information needed for the type of specialist the referral is going to and creates a "package" that is routed using Direct-compliant protocols to MedAllies, which maintains a master directory of Direct addresses for all the physicians in the pilot.
It finds the receiving physician and sends the package to the workflow area of the doctor's EHR.
At that point, the specialist's office staff can open it, schedule the referral visit, and incorporate the patient's data into its EHR.
Once the specialist sees the patient, the system compiles the specialist's report, orders and recommendations and sends that package back through MedAllies to the referring physician, who can add the new information into the patient's record.