Improving the State’s Electronic Health Records

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Electronic health records are supposed to modernize health care, make it more efficient, and improve the patient experience. Some states have a pretty good handle on this, but Connecticut does not.

One of the major shortcomings in the movement to electronic health record-keeping is the inability of different health care providers’ systems to work together. If the information your primary care doctor has on file is in a format that the system at the specialist’s office can’t read, your health record is barely worth the paper it’s no longer printed on.

Minakshi Tikoo, assistant professor in the Center for Quantitative Medicine at UConn Health. (UConn Health Photo)
Minakshi Tikoo, assistant professor in the Center for Quantitative Medicine at UConn Health. (UConn Health Photo)

For Minakshi Tikoo, a researcher in UConn Health’s Center for Quantitative Medicine, the ultimate solution is a system in which any health care provider can retrieve a patient’s most up-to-date health record from an indexed server.

Tikoo’s work to use health information technology to standardize electronic health records across the state is backed by a seven-year, $13 million grant from the Connecticut Department of Social Services. The ultimate goal is to improve patient care.

“The adoption of the electronic health record isn’t the end goal,” she says. “The focus is, how do we improve the care that we deliver by using these electronic health record systems or the health information exchange? How do we send messages from one place to another, for example from hospital to primary care physician when discharging a patient?”

The group of seven Tikoo leads is working on a secure messaging system enabling physicians, dentists, nurse practitioners, and certified midwives to exchange encrypted patient information online, enabling that information to follow the patient to the next provider.

The adoption of the electronic health record isn’t the end goal. The focus is, how do we improve the care that we deliver by using these … systems. — Minakshi Tikoo, Center for Quantitative Medicine

“What we’re focusing on is health IT solutions that are based on standards that increase interoperability,” Tikoo says. “We have got to get this information moving. We cannot put it in packages and just put it in a box and never open the box. And we have to educate people about HIPAA, about privacy and security, about confidentiality.”

HIPAA is the Health Insurance Portability and Accountability Act, the federal privacy rule that provides protections for individually identifiable health information.

“We have to be doing everything we can to make sure the right information for the right patient is with the right doctor at the time it needs to be, so that actions can be made that help improve the care for the person,” says Tikoo. “Our job is to make sure that we identify the best technologies – technologies that are standards-based, scalable, easy to use, and modular.”

Tikoo also is working on identifying gaps in performance using clinical quality measures data, and improving the quality of care by using standardized health IT protocols.

“The analogy I like to use is, it’s like the highways,” she says. “If you didn’t have that infrastructure, you wouldn’t be able to get to places in the time-efficient manner that you are able to. If you don’t have the infrastructure right, you can’t do the connections in a secure manner. You have to get the infrastructure right first, and then you have to work with the people to understand what it is that health IT can do for them.”

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