Creating a Model for Electronic Medical Record Integration with Community Based Clinics: A Demonstration Project Utilizing the Obstetric Medical Record

Significant shortcomings in the system of information exchange and data gathering pervade virtually all sectors of the nation's hea1thcare system. These shortcomings significantly undermine efforts to improve the quality of healthcare, to inform public policy, and to optimize access of at-risk populations to high quality specialty care. These shortcomings are particularly evident in the complex and high-risk system of perinatal care, and especially so in complex care delivery systems such as the perinatal care region served by UNC Healthcare. Though limited data is available to guide the adoption of health information technology in such settings, current evidence and expert opinion indicate that significant improvements in care quality and efficiency can be realized with widespread adoption of this technology and its meaningful integration. The system of information exchange and integration among the providers in our care region is currently inadequate - perpetuating inefficiency, unnecessary work, suboptimal access to care, and inability to generate meaningful data at both the patient and population levels. The long-range goal of this project is to develop a model for transforming the exchange of patient information between UNC Hospitals and community-based providers through the use of compatible electronic medical records - in essence, establishing a health information network for our entire perinatal care region. Electronic patient records (EPR) and health records (EHR) offer an opportunity to improve quality of care, reduce health care costs, speed dissemination of new clinical discoveries to the community and cement partnerships. In addition, data captured within the EPR can be extracted and analyzed to become a powerful tool for clinical research, tactical and strategic planning, and quality monitoring while facilitating the monitoring of factors and outcomes critical to the public's health. UNC Healthcare, recognizing the advantages of the EPR, has been a pioneer in developing a system, web based clinical information system (WebCIS), to meet the needs of providers and patients within the organization. To build on this achievement and extend this technology to our partners in the community is in direct concert with the mission of the of the School of Medicine "to better serve the people of North Carolina and beyond," furthering the UNC goal to become the leading public academic medical center in the United States. The model will be built on the experiences and achievements of this demonstration project which aims to introduce and evaluate the integration of electronic health records between the NC Women's Hospitals' Perinatal Program and the 16 public clinics in its region. These clinics provide prenatal care to 40% of the deliveries at NC Women's Hospital. The intensity of the relationship between these clinics and UNC Healthcare provides an ideal opportunity to develop and test the processes of the electronic transfer of information between organizationally separate but interrelated health care programs. Success with these clinics will set a foundation for larger and larger networks of providers integrating their electronic records.Master of Public Healt