Alabama One Health Record®
In the middle of the night, a surgeon in Mobile takes an injured accident victim straight into surgery without having to wait for someone from the patient’s doctor’s office in Huntsville to find and email records warning of an abdominal aneurysm. In north Alabama, a doctor treats a heart attack victim from Birmingham. Even though the patient’s daughter doesn’t know what medications she takes, the doctor can see that she’s on blood thinner so he doesn’t make the mistake of prescribing too much.The ability to securely access patient records at the point of care, anywhere in Alabama, any time day or night, is becoming a reality through One Health Record®. Although the initiative is being coordinated by the Alabama Medicaid Agency in concert with a 23‐member Alabama Health Information Exchange Advisory Commission, this potentially life-saving resource can benefit any patient with medical records in Alabama, including Medicare and privately insured patients–if every hospital and health care provider joins the cooperative effort.
“It’s also growing beyond the state,” Alabama Health Information Technology Coordinator and program director Paul Brannan, PMP, said. “We’ve recently set up an exchange with Georgia. If one of our patients is in Atlanta and needs care, their doctors can check our records. If one of their patients is in Alabama, our doctors and hospitals that are set up to query can check theirs. We’re also looking at the possibility of cooperative exchanges with other adjoining states.”
The effort to make secure access to patient records available statewide has been more than five years in the making, and was established as Alabama One Health Record three years ago. Over the past year, the program has been picking up momentum.
“We have four hospitals and 20 clinics connected, and four more hospitals in the process of connecting, with the potential for up to 70 more clinics in the process,” Brannan said. “As of now, more than 200 providers are using our secure email and around 20 providers have a query-based connection.”
With the federal push toward electronic records to streamline the exchange of information, similar efforts are underway in every state.
“If a provider in Alabama is interested in connecting, we work with their EMR vendor to develop smooth connectivity,” Brannan said. “There’s no cost for participating in One Health Record, but providers may be able to qualify for funding assistance to set up their electronic records system through the Meaningful Use program and Medicaid. Medicaid providers in particular, especially those who are part of a regional care organization, should watch for new funding that is now under consideration and should become available soon if approved.”
The mission of Alabama’s One Health Record is to improve the quality of the state’s health care delivery system through timely, secure and authorized exchange of patient health information among providers to create one longitudinal patient record to support patient-centered care and improvements in access and outcomes.
A robust website, onehealthrecord.alabama.gov, outlines services, resources and types of information available, including lab results, radiology reports, discharge summaries, consultation notes, history and physical notes, operative notes and referrals. There is a physician portal, and the web-based platform includes sophisticated analytics that assist in applications for state and federal program incentives.
Security of information and the need to protect patient privacy and confidentiality within HIPPA guidelines are top priorities.
“We have strong encryption to protect data, and regular security audits to verify that our safeguards are working and up to date,” Brannan said. “Information can only be retrieved by an authorized user, and patient consent is required before their records can be queried.”
Additional resources are planned for next summer when the program’s technology is scheduled to be upgraded.
“We’re hoping to add public health reporting of immunizations and other data, and to also give hospitals the capability to send out alerts when patients are admitted, discharged or transferred,” Brannan said. “Other features can be added in the future, and we want to talk with participants to determine which functions would be of value to them. For example, we could add a patient portal where patients could retrieve copies of their discharge instructions and report back on how they are doing with their medication and recovery. If this is a function most providers already have in place on their own website, we could focus on other features that would benefit providers and patients.”
One Health Record helps to ensure that all providers involved in caring for a patient—whether in a primary care setting, a specialists’ office or emergency department—have access to a complete longitudinal record of care. Providing a history of previous treatment helps physicians make better- informed treatment decisions. The exchange can also improve care coordination among health care providers to avoid adverse reactions and medication interactions. Treatment isn’t delayed due to lack of records, and referrals don’t have to be rescheduled while waiting for a file.
“The best care happens when complete medical records are available, but it can only happen when everyone who provides care is connected,” Brannan said.