MD-Link gives access to referring physicians
UAMS records available on-line
Physicians from throughout the state — and country — who make referrals to the University of Arkansas for Medical Sciences (UAMS) Medical Center in Little Rock can check their patients' records on-line thanks to a recently instituted program called MD-Link, says Melanie Meyer, director, physician relations, for the College of Medicine at UAMS.
The system is fast, secure, and HIPAA-compliant, Meyer adds, as well as being extremely user-friendly.
The UAMS idea originated at the annual meeting of the American Association of Physician Liaisons (AAPL), she says, where representatives from Dartmouth, the University of Ohio, and the University of Washington shared information on their efforts to provide referring physicians with Internet access to patient records.
"University hospitals are notoriously bad at communicating with referring physicians about their patients," Meyer notes, "and our campus has a long history of being communication-challenged."
The various AAPL members shared their models, and UAMS staff analyzed what others were doing in the field, she says. "Everyone's program is a little different."
The physician relations staff then began meeting with cross-campus groups at UAMS, including legal counsel, outpatient clinic managers, and representatives from information technology, admissions and registration, and medical records, Meyer adds.
The planning phase encompassed about two years, she says, noting that the sessions with the UAMS staff that oversee HIPAA compliance were some of the most complex and time-consuming.
"We had a year of just meeting about forms," Meyer says. "Since these kinds of programs are so new, [HIPAA staff] didn't have anything they could reference. We had to word things so there was no ambiguity. They were very diligent."
Many of the HIPAA concerns involved the process of obtaining patient authorization during registration, she says. "There are many checks and balances within the system to make sure patient privacy is protected."
The process works as follows:
- Patients fill out a form, writing in the name of the physician, either authorizing or denying their referring or primary care physician access to their medical record.
- Registration staff enter the information into the hospital mainframe computer and turn on authorization for the PCP or referring physician. They pick the physician's name from a menu and hit "yes," indicating the form has been completed.
- The PCP or referring physician has to review the UAMS confidentiality policy, and agree to be governed by the same laws and bound by the same agreement as are UAMS faculty.
- After the physician signs a confidentiality/authorization form, the UAMS IT staff mail him or her a password and log-on information.
- The physician goes to the UAMS web site and clicks on the MD-Link logo, then types in the user name.
- At the next screen, the physician types in the patient's name, which takes him or her into WebChart, a homegrown system used by internal UAMS physicians and interfaces with all of the components of the medical records.
- The physician can view discharge summaries, op reports, laboratory and pathology reports, radiology results, electrocardiograms, and outpatient notes, among other patient information.
Before MD-Link, she says, communication was "hit or miss" between referring physicians and UAMS physicians. "Some of our physicians do a really good job of communicating and that's what they teach their departments. But in academic medicine everyone has their own fiefdoms. Not all physicians place the same emphasis and have the same system in place.
"There are physicians who, if the patient sneezes, they dictate," Meyer continues. "There are others who say, 'I'm not writing letters.' Academic physicians struggle to understand [the importance] of communication. They haven't thought that you have to care about the people who are referring you the patients."
Registration staff play a crucial role in the process, as they capture the data regarding PCP and referring physicians, she points out. "That information is critical on any hospital system. It lets physicians know who they need to follow up with, and is also used for billing and appointment scheduling."
Referring information also has a marketing component, Meyer adds. "It lets you know who you're doing business with, probably the most important customer you have."
Some physicians 'dragging their heels'
UAMS began bringing up the MD-Link system in January, she says. After three months of getting patient authorizations on file, she adds, brochures were sent out to the all the referring physicians, both in and out of state, who had sent patients to UAMS within the previous two years.
"Arkansas is fairly rural, so many physicians around the state are still dragging their heels about electronic medical records," Meyer explains. "Many of them don't have computers."
The most interest in MD-Link has been shown by out-of-state physicians who refer patients to the UAMS-based Myeloma Institute for Research and Therapy, she says.
After six months of marketing, about 90 physicians had been enrolled, adds Meyer, who says she believes those numbers will increase "as our physicians are dragged into the 21st century."
Within five years, all physicians are supposed to have transitioned to electronic medical records, she says. "As we make that transition, this program will grow, and we will be ahead of the curve.
"People who use MD-Link think it's wonderful," Meyer adds. "They've been appreciative for the ease with which they are able to access records."
The intent for the future, Meyer says, is that MD-Link will evolve into providing a function whereby an automatic message will be sent to a referring physician when a step in the patient's care takes place.
"It will let the referring physician know that his or her patient has been seen at UAMS and that the record is available for review," she adds. "An e-link will go out."
While it would be convenient for physicians to actually receive the record by e-mail, Meyer notes, "from a HIPAA standpoint, it is so hard to guarantee security."
One of the next steps in this arena is for UAMS patients to have access to their medical records, she says. "We're just now getting the ball rolling on that."
(Editor's note: The Physician Relations office at the University of Arkansas for Medical Sciences is interested in hearing suggestions from other hospitals that have experience with systems like MD-Link and would be happy to share forms or policies and procedures it has developed. Melanie Meyer can be reached at [email protected].)
Physicians from throughout the state -- and country -- who make referrals to the University of Arkansas for Medical Sciences (UAMS) Medical Center in Little Rock can check their patients' records.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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