We've got multiple approaches going, all with advantages and disadvantages. As yet, a winner has not emerged:
1. Kryptiq Clinical Messaging -- you can send outbound TOC, however, it is a manual process. It can be done, but faxing is easier.
It's difficult to manage the outbound Direct email addresses; those which are not published on SureScripts (i.e. most) have to be added into each individual sender's Personal Contacts list. It doesn't scale up.
2. SureScripts Network - We've got a reasonably nice local Centricity market which helps.
Incoming messages from other Network sites can go right to your portal's 'delegate' box, allowing for all messages to be handled easily by staff.
For outbound messages, you can already connect to other Direct systems not published in SureScripts, but which have trusted connections to SureScripts.
We've tested successfully with a Cerner hospital and partially with a Quest360 client (messages work but CCDs don't). Check the SureScripts website to see which EHRs and HIEs in your area are already 'Trusted'. As mterpenning notes, however, there's no easy way yet to get all the addresses.
3. We connected our EMR SureScripts' addresses to our local HIE; SureScripts was very helpful in this.
The main disadvantages of using SMP with outside Direct sites is the Contact list (as described above) and that incoming Direct messages (ex: TOC discharges from hospitals) go to the Doctor's SMPP inbox and not the practice/staff delegate inboxes. We're still trying to figure out a decent EMR workflow, although we have exchanged with Epic and Siemens hospital sites.
SureScripts and the HIEs (ours is HealthShare of Southeastern PA) should eventually use Federated HPD+ to automatically share addresses, since HPD+ seems like it will be the winning directory format. This can't come too soon.
4. We're planning to install the Qvera outbound TOC on top of all the above since it has the potential to automate many of the outbound messages. We still have to connect Qvera to our HIE.
I think it will be worth the money, however, for the benefits of automation, even though we'll essentially have redundant TOC configurations.
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Posted : July 21, 2014 1:41 am
