Interoperability is a guiding principle for Torrance Memorial Health System in its strategy to become a regional health care leader. Clinicians use Cerner Health Information Exchange (HIE), so data for more than 645,900 patients flows securely between various electronic health records (EHR). Clinicians use the HIE, Direct Messaging, and Cerner Hub orders and results to connect the community and provide coordinated care for their patient population. This care also transfers to multiple health systems using various non-Cerner EHRs.
Anthony Chen, MD, a primary care physician with Torrance Memorial Physician Network (TMPN), sees about 300 patients per month.
“The HIE provides up-to-date access to health information from outside our EHR that would otherwise be missing during office visits,” Chen said. “Having the HIE also helps reduce redundant tests and costs for my patients. It has become an integral part of my day-to-day practice and is a great example of how the use of technology benefits our healthcare system in providing better care more efficiently.”
Another benefit of the HIE is assisting ED physicians to have a holistic view of the patient when prescribing medications — particularly when ordering controlled substances.
“We see hundreds of patients a day, and the HIE community view enables me to get a rapid, accurate medical history for the patient before I walk into the room,” said Gina Sulmeyer, MD, chief of emergency medicine, clinical informatics physician advocate.
At times, patients don’t provide complete information because they are embarrassed, forget health information or have different motives, and the HIE allows physicians to know what’s going on behind the scenes.
“I saw a gentleman who averages about 60 to 70 ED visits a year for a chronic issue,” said Sulmeyer. “He’s come in for opioids before and told me he had more problems with abdominal pain, but this was new due to a recent colon cancer diagnosis. When I asked him when he was diagnosed, he said he’d been in another hospital for the last month and had just been discharged two days ago from his first chemotherapy treatment.”
In reviewing the HIE, it was clear there was more to the history than the patient revealed.
“I didn’t see any records on him from the facility he mentioned,” said Sulmeyer. “I told him I couldn’t find any records, so we removed an opioid prescription from consideration, and the rest of the visit went smoothly.”
The HIE community view positively impacts Sulmeyer’s ability to provide care in a fast-paced environment.
“It significantly increases the patient’s confidence in me,” she said. “In emergency medicine, you need to walk into the room and make a rapid connection with a patient. The HIE helps me know a patient’s history. It also helps me assess patients who possibly can’t give me a history, patients who are non-verbal, with dementia, psychiatric patients or patients who forget their history.”
“We were early adopters of the Cerner HIE, and as the solution matured and our use cases evolved, we’ve been able to align our connectivity strategies to the Cerner technical roadmap,” said Bernadette Reid, RN, BSN, CHCIO, vice president of IT and chief information officer. “There continues to be varying levels of integration capabilities among EHR providers, so it’s critical to have an adaptable platform to provide interoperability solutions.”
Health care providers at Torrance can query and retrieve data on incoming patients prior to visits, including last physician office visit notes. From January 2020 to January 2021, Torrance physicians queried external patient records more than 114,890 times. The real benefit of accessing external data is being able to reconcile it into the local record. In that same time frame, Torrance reconciled more than 62,700 outside problems, allergies, medications, immunizations, and procedures to patients’ charts.
Utilizing the Cerner HIE, Torrance Memorial is connected to multiple non-Cerner health systems through the CommonWell Health Alliance® nationwide network. Torrance end-users exchanged more than 830,000 documents from health systems. Physicians from those same health systems exchanged nearly 5,339,600 documents from Torrance. Results are delivered directly to the EHR of the patient's ordering physician and primary care physician, giving clinicians access to outside data within their native workflow.
Torrance hospital end-users can access data from more than 22,000 provider sites in the CommonWell network; the connection to Carequality extends that reach to a total of 50,000 provider sites nationwide.
“During the COVID-19 pandemic, the HIE allows us to share COVID-19 results with providers outside of Torrance Memorial,” said Reid. “Interoperability and working with Cerner is an ongoing collaboration that supports the ever-changing needs of our community.”
Data for this story was pulled utilizing Cerner Lights On Network®.
For more information, check out our Health Information Exchange Model Experience page.