Care Management Support

Patients often find themselves caught in a fragmented and disconnected health care system. Electronic systems can help track referrals to other specialists, laboratory test results, or imaging results to ensure that the recommended care has been accomplished. When patients are referred to other providers or to the hospital, they should be accompanied by the necessary clinical information so that the best decisions can be made, resulting in timely and efficient diagnostic testing or treatment.

Electronic health records should be able to produce a summary of important clinical information that is readable, transportable, and computable; the CCR standard provides a mechanism to do all three. The format allows data to be read by any browser software or to be converted to the readable formats of most EHRs.

Pharmacies now have the capability to capture and transmit data about prescription fills and renewal authorizations. If these data are made available to the physician, he or she can be on the alert for patients who have discontinued medications for a variety of reasons. Pharmacy benefits managers (PBMs) have data on formularies, drug prices, patient responsibility (co-payments), and coverage rules for each health plan contract. This information can be transferred to the EHR to aid in decision support for the physician as the prescription is generated.

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