Inova Alexandria Hospital emergency department clinicians in Alexandria, Va., can now quickly access a patient's prescription information, no matter where in the country they were written, thanks to a recently launched initiative by the Northern Virginia Regional Health Information Organization (NoVaRHIO).

The new service helps providers working with patients in the ED to retrieve and access patient prescription medication information from data sources across the country. Until now, achieving multi-system interoperability using data from disparate sources and seamless workflow integration into an electronic health record was not possible, officials said. They pilot provides a foundation for extending to a full information exchange through the use of Continuity of Care Documents (CCD) and is a step toward meaningful use of electronic health records and health information technology.

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"The NoVaRHIO medication history project has added a new dimension to the care of our patients in the emergency department," said Martin Brown, MD, chairman, Department of Emergency Medicine, Inova Alexandria Hospital. "The system enables comprehensive medication lists to flow directly into our electronic health record, resulting in faster and more focused emergency treatment by helping physicians avoid drug interactions and duplication. This system has helped to greatly enhance the safety of medication use for our patients in the emergency department."

As one example of the power of the new technology, a young girl recently came to the ED with her parents. During the review of the medication, the parents mentioned some of the medications she was currently taking. However, this new service revealed that the child was on strong daily antibiotics for the past six months. Due to identification of this previously unmentioned information, the treating providers were able to better pinpoint the root cause of the girl's symptoms and make an appropriate recommendation for treatment.

HIE value demonstrated

During the initial weeks of service operation, close to 90 percent of patients seen in the ED at Inova Alexandria Hospital consented to having their medication history accessed electronically by the medical staff, demonstrating confidence and a growing recognition of the value of health information exchange (HIE).

By year end, NoVaRHIO estimates that more than 20,000 patients will have benefited from this technology.

NoVaRHIO consists of Northern Virginia hospitals, physicians, business leaders, local governments, health care providers, patient advocacy groups and universities including George Mason University and Northern Virginia Community College.

NoVaRHIO is working with the Commonwealth to coordinate development of its health information exchange with statewide health information exchange initiatives. NoVaRHIO plans to build upon this initial milestone by extending the service to other hospitals and hospital systems, broadening the service to include laboratory and radiology results, allergy, and patient admissions/discharge information, and to offer additional services including physician access and patient personal health records.

This unique project, partially funded by the Commonwealth of Virginia, was the result of collaboration among a number of organizations. Inova Health System contributed substantial in-kind resources to enable this cutting-edge integration initiative.

Inova offered its Alexandria ED as the initial pilot site, enhanced registration and clinical workflows, and provided clinical and technological subject matter expertise to optimize all aspects of the results delivery and use.

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GE Healthcare provided its eHealth Information Exchange as the health information exchange infrastructure along with connectivity to data sources, enhancing its flexible solution to meet Inova's specific needs.

Picis ED PulseCheck, the EHR vendor for Inova's Alexandria ED, enhanced its product to allow for direct import of the medication results, using the latest standards – Integrating Healthcare Enterprise (IHE) profiles and CCD – thereby enhancing workflow and ease of use for clinicians.

Audacious Inquiry, an innovative management and technology consulting firm, provided project management leadership to enable the complex integration project. NoVaRHIO provided executive leadership support and project guidance and led the coalition through the successful grant funding process.

"From its very beginning, this project has been an example of how disparate groups can work together for a common goal--better healthcare," said Phil Reilly, chairman of the board of NoVaRHIO.