Health Information Exchange

Health information exchange (HIE) lets you pull a patient's records from other providers — hospitals, clinics, and labs across the country — without faxing or chasing anyone down. Avon partners with Metriport to query the national networks, and once records come back you can review them and import the parts you want directly into the patient's chart.

How it works

Health information exchange has two directions: what Avon sends out to the networks, and what Avon pulls back in.

What Avon sends

To find a patient on the networks, Avon sends Metriport the patient's demographics: name, date of birth, sex, address, phone, and email. Metriport registers the patient under your organization and uses those demographics to match them against patient records held by hospitals, clinics, and labs on the networks.

Avon does not send the patient's clinical records to the networks. Only the demographics needed to match the patient leave Avon.

What Avon pulls

Pulling a patient's records happens in four stages:

Query: Avon asks Metriport to query the networks for the patient. Metriport sends the request to every connected organization that may hold records for them.
Download and convert: Responding organizations send back their documents. Metriport downloads them and converts them into a standard format (FHIR).
Consolidate: Once every document has been downloaded and converted, Metriport merges them into a single, de-duplicated record set and sends it to Avon.
Import: Avon stores the record set, displays it in the patient's External Records tab, and writes the record types you choose into the chart.

Records are only pulled when you ask for them — the first time you open a patient's External Records tab, or when you click "Refresh records". Avon does not re-query the networks on its own.

Prerequisites

Part 1: Set up the Metriport integration

Health information exchange runs on the Metriport integration. Follow the instructions here to get set up.

Part 2: Complete the patient's demographics (EMR)

Metriport matches your patient against the national networks using their demographics, so the more complete the patient's profile is, the better the match. Avon cannot create the patient's Metriport account unless the patient has a first name, last name, date of birth, a full mailing address (street, city, state, and ZIP), and either a 10-digit phone number or an email address on file.

Follow the instructions here to update a patient's profile.

Steps

Step 1: Create a Metriport account for the patient (EMR)

Each patient needs a Metriport account before their records can be queried. The first time you open a patient's External Records tab, Avon will offer to create one.

To create the account:

Go to the EMR (e.g. emr.avonhealth.com)
Click on the hamburger menu on the top left corner > Patients
Click on the "View Chart" button of the appropriate patient
Click the "External Records" shortcut on the top bar
Click "Create Metriport account for patient"

Creating the account also kicks off the first query, so you only need to do this once per patient.

Step 2: Wait for the query to finish (EMR)

Once the account exists, Avon queries the connected networks, waits for the documents to come back, converts them, and imports them into the chart. The External Records tab shows you where the patient is in that process:

Setting up this patient's external records and pulling from connected networks: Avon is creating the Metriport account and querying the networks. This usually takes a couple of minutes.
Records found. Importing them into the chart now: The records came back and Avon is writing them into the chart.
Something went wrong while importing this patient's records: The query or the import failed. Click "Try again" to re-run it.

The page refreshes itself while a sync is running, so you can leave it open and wait. Larger record sets can take longer than a couple of minutes.

Step 3: Review the records (EMR)

When the sync finishes, the External Records tab displays the patient's consolidated record set in a viewer. This is the full set of documents and resources the networks returned, not just what has been imported into the chart.

Step 4: Import records into the chart (EMR)

You can import a specific set of record types on demand — for example if you only want the medications and allergies, or if you want to re-import after a refresh.

To import records:

Go to the patient's "External Records" tab
Click "Import Records"
Tick the record types you want, or click "Select All"
Click "Import"

The record types you can import are:

Notes: Clinical notes from the outside provider
Conditions: Diagnoses on the patient's problem list
Medications: Prescribed and dispensed medications
Allergies: Allergies and intolerances
Procedures: Procedures the patient has had
Social History: Smoking status, alcohol use, and similar
Vitals: Recorded vital signs
Immunizations: Vaccination history
Family History: Family medical history
Coverage (Insurance Policies): Insurance policies on file with the outside provider
Documents: Documents attached to the outside record
Labs: Lab results
Care Plans: Care plans from the outside provider

Avon tells you how many record types imported successfully, and names any that failed.

Step 5: Refresh a patient's records (EMR)

Records are a snapshot of what the networks held when you last queried. To pull anything new — a hospital stay since the last sync, a new lab result — re-run the query.

To refresh:

Go to the patient's "External Records" tab
Click "Refresh records"

The tab goes back through the same sync statuses as the first query. When it finishes, use "Import Records" to bring the new data into the chart.