scholarly journals Data standards to support health information exchange between poison control centers and emergency departments

2014 ◽  
Vol 22 (3) ◽  
pp. 519-528 ◽  
Author(s):  
Guilherme Del Fiol ◽  
Barbara Insley Crouch ◽  
Mollie R Cummins

Abstract Objective Poison control centers (PCCs) routinely collaborate with emergency departments (EDs) to provide care for poison-exposed patients. During this process, a significant amount of information is exchanged between EDs and PCCs via telephone, leading to important inefficiencies and safety vulnerabilities. In the present work, we identified and assessed a set of data standards to enable a standards-based health information exchange process between EDs and PCCs. Materials and methods Based on a reference model for PCC–ED health information exchange, we (1) mapped PCC–ED information exchange events to clinical documents specified in the Health Level Seven (HL7) Consolidated Clinical Document Architecture (C-CDA) Standard, and (2) mapped information types routinely exchanged in PCC–ED telephone conversations to C-CDA sections. Results Four C-CDA document types were necessary to support the PCC–ED information exchange process: History & Physical Note, Consultation Note, Progress Note, and Discharge Summary. Information types that are commonly exchanged between PCCs and EDs can be reasonably well represented within these C-CDA documents. Conclusions A standards-based health information exchange process between PCCs and EDs appears to be feasible given a set of clinical data standards that are required for EHR certification in the USA, although the proposed approach still needs to be validated in actual system implementations. Such a process has the potential to improve the safety and efficiency of PCC–ED communication, ultimately resulting in improved patient care outcomes.

2020 ◽  
Vol 27 (7) ◽  
pp. 1000-1006
Author(s):  
Mollie R Cummins ◽  
Guilherme Del Fiol ◽  
Barbara I Crouch ◽  
Pallavi Ranade-Kharkar ◽  
Aly Khalifa ◽  
...  

Abstract Objective The objective of this project was to enable poison control center (PCC) participation in standards-based health information exchange (HIE). Previously, PCC participation was not possible due to software noncompliance with HIE standards, lack of informatics infrastructure, and the need to integrate HIE processes into workflow. Materials and Methods We adapted the Health Level Seven Consolidated Clinical Document Architecture (C-CDA) consultation note for the PCC use case. We used rapid prototyping to determine requirements for an HIE dashboard for use by PCCs and developed software called SNOWHITE that enables poison center HIE in tandem with a poisoning information system. Results We successfully implemented the process and software at the PCC and began sending outbound C-CDAs from the Utah PCC on February 15, 2017; we began receiving inbound C-CDAs on October 30, 2018. Discussion With the creation of SNOWHITE and initiation of an HIE process for sending outgoing C-CDA consultation notes from the Utah Poison Control Center, we accomplished the first participation of PCCs in standards-based HIE in the US. We faced several challenges that are also likely to be present at PCCs in other states, including the lack of a robust set of patient identifiers to support automated patient identity matching, challenges in emergency department computerized workflow integration, and the need to build HIE software for PCCs. Conclusion As a multi-disciplinary, multi-organizational team, we successfully developed both a process and the informatics tools necessary to enable PCC participation in standards-based HIE and implemented the process at the Utah PCC.


2012 ◽  
Vol 50 (6) ◽  
pp. 503-513 ◽  
Author(s):  
Mollie R. Cummins ◽  
Barbara I. Crouch ◽  
Per Gesteland ◽  
Nancy Staggers ◽  
Anastasia Wyckoff ◽  
...  

2018 ◽  
Vol 09 (03) ◽  
pp. 553-557 ◽  
Author(s):  
Mollie Cummins ◽  
Pallavi Ranade-Kharkar ◽  
Cody Johansen ◽  
Heather Bennett ◽  
Shelley Gabriel ◽  
...  

Background U.S. poison control centers pose a special case for patient identity matching because they collect only minimal patient identifying information. Methods In early 2017, the Utah Poison Control Center (Utah PCC) initiated participation in regional health information exchange by sending Health Level Seven Consolidated Clinical Document Architecture (C-CDA) documents to the Utah Health Information Network and Intermountain Healthcare. To increase the documentation of patient identifiers by the Utah PCC, we (1) adapted documentation practices to enable more complete and consistent documentation, and (2) implemented staff training to improve collection of identifiers. Results Compared with the same time period in 2016, the Utah PCC showed an increase of 27% (p < 0.001) in collection of birth date for cases referred to a health care facility, while improvements in the collection of other identifiers ranged from 0 to 8%. Automated patient identity matching was successful for 77% (100 of 130) of the C-CDAs. Conclusion Historical processes and procedures for matching patient identities require adaptation or added functionality to adequately support the PCC use case.


2011 ◽  
Vol 18 (5) ◽  
pp. 690-697 ◽  
Author(s):  
Kevin B Johnson ◽  
Kim M Unertl ◽  
Qingxia Chen ◽  
Nancy M Lorenzi ◽  
Hui Nian ◽  
...  

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