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July 20 - Vermont Governor Highlights E-Health Projects, Visits Innovative Medication History Service

In an emergency situation, physicians and nurses need accurate information about patients in a hurry. An innovative health information technology project now running in two Vermont hospital emergency departments is meeting that need, by delivering accurate medication lists within seconds, even if a patient has never visited the hospital before.

Vermont Gov. Jim Douglas toured the Rutland Regional Medical Center's emergency department to see the new service in action, and to highlight the role of information technology in improving health care quality and controlling costs.

Gov. Douglas is the co-chair of the State Alliance for e-Health, an initiative of the National Governors Association which brings together governors, attorneys general, state legislators, insurance commissioners and other experts to address state-level health information technology issues.

"It's projects like this one that demonstrate the power of health information technology to improve health care and make our health care system more efficient and more affordable," said Gov. Douglas. "In Vermont we're committed to bringing innovative technology like this to hospitals and physicians' offices in every part of the state."

Gov. Douglas also noted that the medication history service developed in Vermont is considered the most effective in the country because of its high level of data availability. Medication data is available on 75% of the patients visiting the emergency department, due to the unprecedented cooperation of major payers, including Blue Cross Blue Shield of Vermont, MVP Healthcare, and the Vermont Medicaid program. "By accessing in real-time claims data from insurers and other payers, physicians and nurses have a more complete picture of the medications their patients are taking. This is a powerful new tool to increase patient safety and reduce drug interactions," Gov. Douglas said.

The medication history service is offered by Vermont Information Technology Leaders, Inc. (VITL), Montpelier, Vt., a not-for-profit public-private partnership. GE Healthcare, South Burlington, Vt., developed the service for VITL and provides maintenance and support for the hospitals. Rutland Regional Medical Center and Northeastern Vermont Regional Hospital in St. Johnsbury are the first two hospitals in Vermont to implement the new electronic medication history service in their emergency departments. The service will be rolled out to other hospitals in the state over the next year.

Data from prescriptions filled at pharmacies is being provided by pharmacy benefit managers (PBMs), including RESTAT, West Bend, Wis., and MedMetrics, Worcester, Mass., the PBMs for Blue Cross Blue Shield of Vermont and Vermont Medicaid, respectively. Playing a central role in the project is RxHub, LLC, St. Paul, Minn., which electronically routes up-to-date patient-specific medication history and pharmacy benefit information to caregivers at every point of care.

"RxHub is pleased to be partnering with GE Healthcare and Vermont Information Technology Leaders, Inc., in bringing together the key stakeholders to provide real-time access to patient medication history information for more than 75% of the citizens within the state of Vermont," stated JP Little, chief operating officer for RxHub. "The impressive results achieved by this collaboration will set the bar for other initiatives across the country. By providing medication history in the hospital setting, indications of potential drug duplications, adverse drug events, and patient compliance with prescribed therapy are evident and result in improved patient safety."

Patients arriving at the emergency department are asked for permission to access their electronic medication history. Almost all choose to opt in. They like the convenience of the service and the increased patient safety.

"It was much easier to look up my medications electronically than having me try to remember them. When you come to the emergency department and you don't feel well, it's difficult to remember what medications and dosages you're taking. So it was much easier for me to look at the medication history list on paper to verify," said Anthony Bizzaro, 60, of Shrewsbury, Vt., who recently was a patient at the Rutland Regional Medical Center's emergency department.

Health care professionals working in the hospital emergency departments say their patients have benefited from the availability of electronic medication histories.

"Before we asked patients for a list of all the drugs they are taking, or we had to look through bags of pills that patients brought with them. Many times, these lists were old or the bag had medication in it that was old and we did much guessing," said Irene Fortin, RN, a nurse in the Rutland Regional Medical Center emergency department. "Now with the electronic medication history, we have the drug names with the latest filled dates, which guides us and all we have to do is verify with the patient that the information is correct." This also allows patients to be treated more quickly, she adds.

"The VITL electronic medication history service gives me a list of prescriptions filled on emergency patients that I see. Something as simple as this was previously unavailable; I have personally found it invaluable for safe and efficient patient care," said Dr. Harry Chen, an emergency physician at Rutland Regional Medical Center.

"An accurate list of current medications is so important to good patient care. The electronic medication history is another tool we use to ensure patient safety and quality care during their visit to the emergency room," said Debbie Bach, BSN, RN, director of the Northeastern Vermont Regional Hospital Emergency Room and Walk-in-Clinic. "This technology has much potential."

Cooperation from payers, practitioners, hospitals, vendors, and state agencies was key to the project's success, said Gregory Farnum, president of VITL. "This service shows the value that VITL brings to improving Vermont's health care system," he said. "As a public-private partnership, VITL can bring various stakeholders together to devise creative solutions like this one."

The electronic medication history service is VITL's first pilot project. VITL and GE Healthcare will be working together to develop and implement other standards-based health information technology projects, said Bill Howard, program manager at GE Healthcare. "This project was an important first step and from here we'll be able to work with hospitals and physicians to implement more complex projects that will help them deliver better and more efficient care for Vermonters."

Source: GE Healthcare

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