Abstract 2604: Will “Real Time” Access to Electronic Medical Records Improve Telemedicine Stroke Consults?
Objectives: The Neuroscience stroke telemedicine program of the Medical University of South Carolina (REACH MUSC) is a robust network of 15 sites served by an academic hub in Charleston. South Carolina’s Health Information Exchange (SCHIEx) collects and displays data from all hospital discharges and emergency room visits. At present, our REACH MUSC stroke consults, like most, are not connected to a central electronic medical record or Health Information Exchange (HIE) like SCHIEx. We used our first 250 REACH MUSC consults to estimate the value to a stroke telemedicine consult of a hypothetical “real time” connection to an HIE.
Methods: After IRB approval, names and identifying information of the first 250 consecutive REACH MUSC stroke consults were provided to the SC Office of Research and Statistics for analysis, along with 10 prespecified questions of interest based on their presumed value in the stroke setting (e.g. “can a history of atrial fibrillation be found?”). A retrospective search of 10 years from the date of the consult was performed using data available also available via SCHIEx. The REACH MUSC consult itself was examined using the same template and the two compared to see if relevant information would have been found in SCHIEx that was not obtained during the actual REACH MUSC consult.
Results: 249 unique patients were represented in the 250 REACH MUSC consults and, of these, 234 could be located in SCHIEx (others were probably tourists). Much information found on the 234 in SCHIEx was in the form of comorbidities and would not have been of crucial value to the REACH MUSC stroke consult. However, 4 patients in SCHIEx had a history of intra-cerebral hemorrhage and only one of these was noted in the REACH MUSC consult. 24 patients in SCHIEx had a history of “atrial fibrillation” but this history was recorded in only half of the REACH MUSC consults. SCHIEx does not yet have medication data so information on warfarin use was not available.
Conclusion: This study suggests that real time linkage to an HIE or other sources of historical medical data might indeed improve the quality of stroke telemedicine consultations, at least from a safety perspective.
- © 2012 by American Heart Association, Inc.