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Synchronizing EMR and PACS

September 25, 2014
From the July 2014 issue of HealthCare Business News magazine

By Cree M. Gaskin

Synchronization of the EMR and PACS so that both simultaneously display information on the same patient can enhance patient care by creating an environment in which radiologists have a more holistic view of the patient while simultaneously enabling efficient sharing of information between referring physicians and radiologists.

The groundwork for this improved interaction is the growing use of EMRs in physicians’ offices, imaging centers, urgent care facilities and hospitals of all sizes—driven in part by Meaningful Use legislation.

Broader use of EMRs has led to sharing of more comprehensive electronic information about patients. Prior to EMRs, I would routinely read imaging exams knowing only the age, gender and maybe a phrase of clinical history of each patient. Now I have access to each patient’s full medical record, including pre-filtered, boiled-down data relevant to me, when reading an exam.

Providers often order imaging studies electronically, which enables them to quickly input information from their evaluation of the patient. In the past, an order might say “man with hip pain,” whereas now the content is more detailed such as “48-year-old man with hip pain, subjective fever and marked increase in pain over the last two days.”

Communication between radiologists and other physicians is also improved. I might read an outpatient exam and see a major unexpected problem, such as metastatic cancer in a patient presenting with low back pain. I can add a personal note to the report that says “urgent – unexpected metastatic disease.”

This note is flagged by the EMR as an MD to MD note. It grabs the attention of the referring provider when he logs into the EMR and I can see when the provider has read my note. This closes the communication loop and I know the patient is being taken care of. If my note is not viewed in a timely fashion, perhaps due to a vacation or meeting, then I will contact a different physician at the provider site to make sure they know about this patient’s scenario.

Another example of improved communication is a case where a patient presents in the ED with an ankle injury. The ED physician looks at the X-ray, believes the ankle is sprained, marks this in the EMR and initiates discharge orders. The radiologist detects a fracture — and marks his diagnosis as a discrepancy in the EMR. This discrepancy creates a flag in the record, which is seen by the ED nurse who then halts the discharge and holds the patient for needed treatment.

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