The HITECH Act, as a part of the American Reinvestment and Recovery Act (ARRA), clearly was the accelerant for the adoption of electronic health records systems (EHR). In the United States, through a series of financial incentives, providers were encouraged to install these electronic systems to record their patient information. It is little surprise that without specific financial incentive to do so, the original design of most EHR systems did not include medical imaging.
When it comes to connecting medical imaging systems to electronic health records systems, not all EHR systems (or vendors) were created equal. If you are considering adopting an EHR or changing out your existing EHR, you should consider in advance whether you might want your patient medical images accessible along with your patient medical records. If so, you ought to ensure that your EHR vendor will support you in that process and whether there will be additional charges imposed to get their assistance. You shouldn't be surprised to learn that you can negotiate your EHR vendor's compliance with this request much more readily (and less expensively) if you do this before you agree to your purchase.
The vast majority of physicians agree that a medical record without a related medical image is missing an integral part of the complete patient health picture (pardon the pun). And virtually all would prefer to not have to run two separate systems side by side to get at both the record and the image.
Some PACS vendors are practiced at connecting their imaging systems to an EHR system. However, not all EHR systems designs include a viable path to connection and not all EHR vendors are amenable to aiding them.
Here are some questions to ask and negotiate with your EHR to ensure that when you decide to integrate your PACS, the path will be as smooth as possible.
- Inquire about the fees they will charge to document and provide an API (application programing interface) that enables third party applications to connect electronically with your EHR. Be sure they have an API, that it is documented and exposed, that they will assist your PACS vendor by providing technical advice. Most important is that you get them to verify in writing what the future charge will be (if any) for this function. If they do charge, understand what those charges will be (both one-time and ongoing) in advance of your agreement
- Ask if their API will enable a URL connection to a patient record. They will know what this means – but for purposes of your knowledge, this is an Internet addressable location that will enable imaging studies to be launched through the creation of a simple, elegant link (or button) within their product. The fastest integrations we’ve achieved for our customers use URL-based integration methods. Many of the most popular EHR systems support this, and it makes integration a breeze. Verifying this in advance will be very helpful.
- Make sure your vendor supports HL7, and ask them to prove it. While many EHR vendors say they support HL7, their depth of knowledge is often very limited, preventing successful integrations from ever happening. Don’t hesitate to ask them to prove it, by inquiring about integrations with other systems they’ve achieved in the past on behalf of their clients.
This ounce of prevention can be very helpful (and cost saving) when the time comes to integrate medical images with your electronic patient records.