As a provider of outsourced telephone nurse triage services, AccessNurse is frequently asked to implement the interfacing of a client’s Electronic Medical Record (EMR) system with our documentation system.

EMR implementation can have great benefits and a variety of solutions depending on each client’s needs. To ensure the most appropriate method of interfacing a client’s EMR with our documentation system, the AccessNurse team first gathers the client’s responses to several questions, such as:

• What are the client’s objectives and requirements (e.g., what clinical information does the nurse need to see versus what is already available in the call center’s triage system and processes)?
• What information should be passed back to the EMR?
• Are there any requirements that can only be satisfied by providing EMR access to the nurse?
• Does the client have a document management system that can be utilized in the solution?
• What client resources are available for the project?

Logging into a client’s EMR may seem like the easiest solution, but there are a number of considerations that must be addressed prior to deciding whether to implement an EMR interface. For example, in an integrated call center, every nurse would need to meet the organization’s security requirements for obtaining and maintaining logins. This often requires substantial effort and ongoing management. In the case that the EMR does not have triage guidelines or other components required to drive and report calls, the nurse would be required to use the call center triage system as well as the EMR, which can create inefficiencies and opportunities for errors.

Instead of logging into the client’s EMR, it may typically be more efficient and appropriate to limit the fields that the nurse can view and to automate the process of transferring the information to and from the EMR and triage documentation system. Automated options can meet providers’ needs, improve efficiencies, and reduce the risk of clinical error. AccessNurse uses different interface methods, including HL7, image transfers, web portals, flat file transfers and single-sign-on to directly populate the EMR and the triage documentation system.

After the client’s objectives, vision and requirements are identified, a collaborative plan can be created to meet and exceed the client’s goals.

Lorin Fetzer is Vice President of Information Technology for AccessNurse.