For nearly a decade, Texas Children’s Pediatrics (TCP) has entrusted TeamHealth Medical Call Center (THMCC) with providing quality after-hours triage and clinical advice to its patient base of nearly 500,000. During that time, THMCC has performed more than 500,000 encounters that were documented and communicated back to TCP via fax. Those generated documents required TCP personnel to manually retrieve, sort, prioritize, and ultimately file those documents within each patient’s medical record—creating numerous hours of work that in turn generated additional labor costs for TCP.

When TCP began looking for an electronic medical record system, it became apparent to TCP and THMCC that there was an opportunity to save valuable clinical resources and simplify physician review of after hours triage encounters by leveraging the workflow capabilities of their new system. After TCP implemented EPIC throughout their organization, TCP and THMCC collaborated to develop an interface that enabled the two organizations to exchange data and documentation. Using Health Level 7 Standards (HL7), TCP can now sends specific patient information, including a medical record number (MRN) to THMCC, who then uses this patient information to create triage encounter documentation when the parent of a TCP patient calls and requests after hours services. By using existing TCP data, THMCC can send the encounter information back to TCP in a format that is recognizable to TCP’s EMR system.

When a telephone triage occurs, THMCC creates a PDF document of the patient encounter as well as an accompanying index file in .txt format. Index file data ties patients to their EPIC EMR, their physicians’ practice, and the triage documentation. Upon completion of the triage event, these documents are transferred to a pick-up location using File Transfer Protocol (FTP).

TCP collects patients’ documents from THMCC at regular intervals using OnBase, their enterprise content management (ECM) system, and using the data in the index file, OnBase distributes the documents into the EPIC workflow process that validates the data and subsequently routes the triage encounter to practice-specific work queues. Medical personnel responsible for these work queues review the documents, follow up with the patients, and escalate patient review and care to physicians as needed,

The electronic documentation generation and interface between THMCC and TCP’s EPIC system has sped up getting needed information to patients’ physicians faster so that patient care and safety are improved. An additional benefit of the TCP and THMCC collaboration effort has been a reduction in TCP’s costs associated with the time required for personnel to retrieve, sort, prioritize, and file printed documentation and the elimination of a cumbersome, paper-dependent process.