Nov 18, 2014

Dr. Miller: You're traveling and you find yourself in an emergency room in a different city, how can you get access to your medical records from your doctor where you live? This is Dr. Tom Miller and I'm going to talk about that next.

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Dr. Miller: Hi, I'm here with Dr. Mike Strong, Mike is the Chief Medical Informatics Officer for the University of Utah. Mike what about when you're in another city, you get sick, you need care, how can you get access to your doctor's records?

Dr. Strong: There's a couple of different ways that that's done. Some are easy; some are a little more difficult. If the hospital that you're visiting happens to be on the same electronic medical records system, so for example here at the University of Utah, we partner with a company called Epic that makes our electronic medical record. Many, many hospitals throughout the country are on Epic as well. If you're at a hospital that has Epic then they have instant access, they can see the whole record. They can see everything that they need to see. If you're at a hospital that has a different electronic medical record, then we do have ways of sending that information over the Internet.

Dr. Miller: This is far advanced compared to the time when we had paper charts in offices, it would be literally impossible to get that information.

Dr. Strong: Oh yeah. In the days of paper records you'd have to fax information. That would take, you know, someone having to go down, actually find the chart, figure out what part of the chart to send, then fax it.

Dr. Miller: So let's say I'm in Hawaii. I go swimming, I get stung by a big jellyfish and then I feel miserable. So I end up at the local ED. How do they get hold of my record? What do I need to tell them?

Dr. Strong: So you just need to tell them what hospital you're cared at. They can contact us; find out what system we're on.

Dr. Miller: So they could contact University of Utah at any time?

Dr. Strong: Any time. Our medical records people can send that information electronically to them if they also have a system that can accept it.

Dr. Miller: Would there be a number that our patients could use? A phone number or an email address that they could contact?

Dr. Strong: They would just call the hospital operator, our general number, and ask for the medical records department who could help facilitate that.

Dr. Miller: Our general number is 801-581-2121, and they could ask for the medical records department. That's staffed 24/7 right?

Dr. Strong: Absolutely. The other nice thing is that our electronic medical record has a patient portal, and that actually is available just through a smartphone app. Now admittedly that doesn't have the entire medical record but it has...

Dr. Miller: That's great. It has pertinent things in it doesn't it?

Dr. Strong: ...oh it has some very pertinent things. So it has their medication list, it has their allergies. It has their problem list.

Dr. Miller: Problem list.

Dr. Strong: All of those things are right available just on their smartphone, and they could just show that to the physician where they were.

Dr. Miller: So when they're in the ED the one they could do... they could either pull it up on their app if they have an app.

Dr. Strong: Yep.

Dr. Miller: And I'll ask you how they'll obtain that app in a minute. But they could also pull up their Mychart site, which is their portal into the medical record for the physician in the clinic, by typing into the Internet.

Dr. Strong: Absolutely. That'd be an easy way to do it. And that would give that physician a ton of valuable and important information.

Dr. Miller: And how does the patient sign up for either the app or the portal?

Dr. Strong: So, any time a patient comes to one of our clinics, all they have to do is say that they want to be signed up. We give them an activation code, and they go online or they go to the app store and download the app. Put in the activation code, that's it.

Dr. Miller: Would there be a way for a patient travelling in a foreign country, you know, China maybe, Taiwan, some place like that, to have a file, like a PDF file on a flash drive?

Dr. Strong: Yeah. If they were traveling and they wanted to carry important parts of their medical record. All they would have to do is come into the Health Information Department, and they could get a copy of their medical record, and put it onto a flash drive and carry that with them.

Dr. Miller: Now let's turn it around a little bit. Let's say that I'm in another city and I end up needing some x-rays. Maybe I have pneumonia and I see somebody and they have chest x-rays. I end up back home, would the facility that had the x-rays done, would they be able to send those to our facility electronically? How does that work?

Dr. Strong: They do. We actually have system here SeeMyRadiology. It's a service that we subscribe to that allows us to hook into almost any other facility and have them send us the images digitally.

Dr. Miller: How would that occur? What does the patient need to do? Does the patient need to do anything or is the doctor just able to get online and do that when the patient is in clinic with them?

Dr. Strong: Actually our radiology department helps facilitate that, so it's just like any kind of a records request. They will contact that institution where the x-rays were done and make a request.

Dr. Miller: Where could there be a breakdown in all of this for either the patient or the physician?

Dr. Strong: Well right now the biggest area is a breakdown...there are a variety of different electronic medical record vendors. And right now...

Dr. Miller: It's like railroads in the old days they had different gauge railways and they're all sort of operating on their own platforms and they don't all talk to each other.

Dr. Strong: Exactly and they don't all talk to each other. And so that's where some of the difficulty comes. The good news is that the federal government has mandated that every single vendor develop the capability of communicating with any other vendor. And, you know we're a few years away from having that totally implemented throughout the country, but it's coming.

Dr. Miller: So one, it sounds to me like most of the patients that are being seen here, all of the patients that are being seen here should sign up for the portal entry into the electronic medical records. So if they're traveling they can pull up very significant parts of their medical history, which would include allergies, and drugs, and problem lists for physicians to look at if that needs to happen. And they can do that online, in the emergency department, or doctor's office, wherever they are. That's one. And then secondly they can also have an app put on their smartphone to get into the portal as well.

Dr. Strong: Absolutely. It's really very easy.

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