Citywide electronic health information exchange



Individually tailored anti-clotting medication dosing significantly cut the rate of adverse events after non-emergent percutaneous coronary intervention (PCI) with stenting, researchers reported at the American Heart Association’s Scientific Sessions 2008. Results of the Tailored Clopidogrel Loading Dose According to Platelet Reactivity Monitoring to Prevent Stent Thrombosis study were presented as a late-breaking clinical trial.

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Across the nation concerns about health-care quality and costs are growing. For the first time, both candidates aspiring to the nation’s highest office are looking to greater reliance on electronic medical records as critical to any remedy.

In Indianapolis, they and the nation can see first-hand how significant a part of the solution electronic medical records can be, say Indiana University School of Medicine researcher-clinicians at the Regenstrief Institute. Regenstrief investigators have been working on and with electronic medical records since the infancy of the concept nearly 40 years ago.

Today the Regenstrief Medical Record System has a database of 9.6 million patients. It has given birth to the Indiana Network for Patient Care, the nation’s only citywide health information exchange. This metropolitan system allows emergency department physicians, with the patient’s permission, to view as a single virtual record all previous care at any of more than 25 hospitals, improving quality of care and the efficiency of delivery of that care.

Electronic medical records offer numerous advantages over paper records which are sometimes illegible and very often not where the patient is when he or she needs treatment. Because an electronic medical record allows the doctor to instantly see the patient’s prior treatment, medication history and other details critical to care, errors decrease.

Electronic records also promote preventive care, improving health and lowering costs. For example, the medical staff can be electronically prompted to offer an older individual a pneumonia shot or to remind the patient of the need for colonoscopy. And by preventing pneumonia or by diagnosing cancer at an earlier stage, electronic medical records can substantially reduce health-care costs. Paul Dexter, M.D., Regenstrief research scientist and IU School of Medicine associate professor of clinical medicine, has authored a study in the Journal of the American Medical Association which found that computer assisted standing orders improve adult immunization rates.

Shaun Grannis, M.D., a Regenstrief research scientist and an assistant professor of family medicine at the IU School of Medicine, is building upon this work to improve syndromic and bio-terrorism surveillance. He leads a multi-year project to integrate health data from nearly 110 hospitals throughout Indiana for use in disease surveillance and has worked with other states including Texas and Michigan to develop statewide data sharing initiatives.

Protecting patient privacy is also an area of significant Regenstrief research. A study by Jeff Friedlin, D.O., in the September - October 2008 issue of the Journal of the American Medical Informatics Association discusses a new Institute computer program that accurately and rapidly removes or “scrubs” patient identifiers from medical records thereby preserving privacy. Dr. Friedlin is a Regenstrief research scientist and an assistant professor of family medicine at the IU School of Medicine.

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