Once Upon a Time

The best stories have happy endings. Luckily, our stories are the best.

The Rochester RHIO (The Patient Portal)

Way back in 2008, the Rochester RHIO was dreaming up all sorts of great things. Like most RHIOs, they envisioned a world of interoperability through their HIE, but instead of focusing all of their energy on getting participating providers, they also wanted to engage consumers. After launching an easy-to-understand marketing campaign, the Rochester RHIO started seeing almost all consumers granting consent. On paper. And this is where Fusion came in.

The team at the RHIO wanted to take consumers farther. Since patients were giving informed consent on paper, they'd probably do it online too. And that would be much more convenient for the providers, for the RHIO, and for the patients. Fast-forward 3 years. Right now, patients in 11 counties around Rochester can log into the RHIO's Patient Portal to manage their consent online.

And that's not all: pretty soon they can also link their Portal account with a PHR to grab their data from the HIE. And attach copies of important advance directive documents to the RHIO's XDS.b registry. And even allow their health plans to use the RHIO for case and disease management programs. How's that for a happy ending?

Electronic Medical Orders for Life Sustaining Treatment (eMOLST)

If we were forced to choose only one word to describe Dr. Pat Bomba, we'd have to say "passionate." The MOLST form is easily considered her life's work, and we are very lucky to be a part of this project. The MOLST form carries instructions for how a patient should be treated at the end of their life. Following the orders ensures the patient's wishes will be carried out, so their life will end with dignity. In 2009, Dr. Bomba was busy working on a pilot to take the paper MOLST form and create an electronic version. By early 2010, she was ready to go.

Fusion has been working on eMOLST with Dr. Bomba for the past 14 months. The application allows credentials healthcare providers at participating practices to document their MOLST discussions with patients, create and share drafts of MOLST forms, and electronically sign completed orders. These orders are then rendered into a PDF, which can be attached to an EMR, printed and carried with the patient, and also sent to the Rochester RHIO's XDS.b registry for exchange across the community.

Yep, this application is pretty cool. Creating and exchanging these documents electronically keeps these orders available to everyone who needs them, whenever the need might arise. We can pull up copies of eMOLST forms using an iPhone app. We can encapsulate them into a CCD and pass them to any system. We're in the process of piloting the application with real practices in the Rochester area, and we're looking forward to an interoperable future where all medical orders are managed online - not just MOLST.

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