Home Forums Discussions General Discussion CCR -- Importing and Exporting

So as I continue to play with v5 and future and present capabilities, can someone tell me how CCR (Continuity of Care Record) works or is supposed to work?

As a specialist, the idea of importing a CCR for me is outstanding. If my referring docs use an EMR and export a patient's CCR to me (somehow), I import it into AC, and suddenly I have all of the patient's demographics and most importantly, their medications and allergies? Is that how it works?

If it is, that would make an EMR invaluable. How would a referring doc send me that file securely in electronic format?

Maybe I'm an idiot and I don't have a clue what I'm asking about and living in a pipe dream.

Travis - there are several ways to accomplish this, some easier than others.

General approaches:
1>Email and/or File Encryption
2>Transparent (SAAS) Messaging encryption
3>Messaging Portal

Unless the Doc you are messaging has propeller-head tendencies, #1 is out. It is great stuff, but requires someone to manage the encryption or shared/private keys. There are SAAS providers that offer on-demand encryption, but you would both have to subscribe to the service.

#2 is an easier-to-use approach, and may allow a non-user to go to a site to open the email, but you will have costs associated.

#3 is another option, and happens to included in UpDox if you are using them already. The message is routed to the other Doc, and you aren't charged anything for the message/file transfer.

Unless you are a big enough shop to pay someone to manage encryption tech and keys, I'd recommend options #2 or #3.

Indy-
Can you explain in more detail specifically how an Updox user could share records? How about the specific example given by Travis; a referring doc wants to share records, demographics, etc. with a specialist.

Jon - I need to touch base with Tobin Juday (of UpDox), but I believe it is much the same as messaging a patient.

I'll look into the specific use case, then get the details and return to this thread to update it.

Some genius will figure out a way to fax the info in .xml format and we, on the other end, can just import it from our fax system. That way, nothing changes on either end except for file format.

This may exist somewhere and I'll do some research on it today. I have two very strong primary docs who are quite good with their EMRs. If I can figure this out, they will be more than happy to work on this together.

Indy, great stuff as usual. #2 seems to be the most viable option unless UpDox works.

The next generation of doctors that we mentored are going to embrace all of the digital media whether there is HITECH or not. Unfortunately, our generation has difficulty with it. And, remember, there is a selection bias for those on the board.

www.certifiedmail.com will is completely HIPAA compliant. (I have to admit I don't recall its attachment capabilities. It is relatively inexpensive. I used to use it. ALL a doctor on the other end had to do was click on the link in the email, it would take him/her to the secure site, automatically fill in his or her email as the user name. They would simply need to type in a password. It was free for them, and they could access the data after logging in. From that time forward, they just entered the password.

I would hazard a guess that over 50% would email be back via regular email and ask that I sent the email in the "normal fashion." So, I would oblige and type. I have a patient, A.R., with anemia, etc. They either couldn't figure it out or more likely from what they told me, they were afraid they would incur charges and have to have an actual account.

But, on the other hand, just having it may fulfill the requirement. Again, I don't know how much bandwidth you are allowed.

A couple of thoughts/questions along these lines:

I have some snowbirds getting ready to leave for the winter and have asked them to bring in thumbdrives to export their CCR onto...which is quite simple. I also figured out a way to export their AC notes by selecting the encounters only button in the past encounters tab and exporting/saving this file (sorry, don't remember exact names of buttons and I don't have AC in front of me).

What about the imported items though? I can individually open each item and then save it to the thumbdrive...is there a way to select all imported items and export? Is this an option under "print entire record" that I am not seeing? I also have nightmares such as AC going out of business and then I have to find some way to move all of these imported .pdf items to another EMR...and how could you do this with thousands of charts and exponentially more imported items?!?!?

I talked with AC and they are still working on improving the PRINT ENTIRE chart - I have discussed the need to be able to print/export in different fashions, eg 1- the whole chart including imported items, 2-the whole chart including imported items by date range (1/1/90-1/1/92), 3- some other fraction of the chart.

Currently if I want to transfer records I do the following:
1) Print entire chart from previous encounter page - I print to a PDF converter (PDFill.com - great and free) - this saves all the encounter notes, messages, etc as a single pdf
2) I then use PDFill tools to go into imported items folder in AC and look up the file number, eg 2259 which corresponds with the AC ID number on the main demographics page. I then use the combine function to take the main file from step 1 and then click on all the other PDF files and hit combine - this makes one pdf file I can burn onto CD, e-mail using a program like Bert's above or UPDOX. The only thing this leaves out is the letters I have sent the patient (currently saved as HTML - I have had numerous discussions with AC and hope that eventually they will save this as PDF also). I really don't think this matters.