AAFP supports concept: Excitement grows about continuity-of-care record

AAFP supports concept
Excitement grows about continuity-of-care record

BY SHERI PORTER

Sometimes a great idea needs time and tweaking before it comes to fruition. Such is the case with the continuity-of-care record, an idea initiated by the Massachusetts Medical Society several years ago. The CCR is poised to become available to physicians and their patients this spring.

The CCR is an ongoing record of a patient's care, "a summary at any one point in time," said MMS President Tom Sullivan, M.D., who co-chairs the society's CCR work group. The record can be updated after every health care visit and be made available to the next health professional or facility. The CCR's purpose is to provide current and accurate information to each health care provider down the chain. Whereas the electronic health record contains the patient's entire health record, the CCR incorporates basic information and can become part of the EHR.

"I would say that the CCR standard, once adopted, represents a major step toward achieving some of the aims of the Institute of Medicine in improving health care in this country," said Sullivan. "This will have a big impact on patient care, patient safety and health care efficiency."

Early evolution

A Massachusetts Department of Public Health document a patient care referral form in use for 30 years provided Sullivan with a CCR starting point. He simply put the document into an electronic format.

Next, ASTM International, a not-for-profit, nongovernmental organization that develops standards, was brought in to facilitate the standard-setting process.

That step gave the project steam and credibility, and in August, AAFP threw in its support. The Healthcare Information and Management Systems Society also backs the effort.

"AAFP is the first physician organization to join us," said Sullivan. "AAFP saw the light, and I give credit to its leadership in getting information technology to the real world of practicing physicians."

CCR components

According to a CCR concept paper on the ASTM Web site (a link to the site is noted below), a portable patient record must incorporate specific elements, including:

document-identifying information such as "to and from" information and the date and purpose of the patient visit;
a reason-for-referral section;
patient-identifying information such as name and address;
patient insurance and financial information;
patient health status, including diagnoses, allergies, current medications, immunizations, vital signs and laboratory results;
care documentation such as detail on recent patient-clinician encounters; and
a care plan outlining recommended tests, procedures and regimens of care.

What makes the CCR stand out is its simplicity. "This is something that's never been done before," said Kathleen Bellisle, a Massachusetts Medical Society manager who has been working on the project for more than a year.

She said other proposed solutions to the portable patient record dilemma were too complex. "People were trying to create interfaces to disparate systems. What we've done is create something in a standard XML format, making it easy to transmit information back and forth between systems."

Close to fruition

For months, stakeholders in the CCR project have held meetings (including an Oct. 23 meeting at AAFP headquarters in Leawood, Kan.) and invited all interested parties to comment on the evolving document.

"You don't have to be a member of ASTM to provide input," said Dan Smith, an ASTM manager who's been involved with the CCR project. "You do have to be an ASTM member to cast a vote when the ballot opens."

At press time, the ballot for the proposed CCR standard had yet to be posted on the ASTM Web site. If it went live in mid-January as planned, the next step would be a 30-day period for voting and then a probable March meeting to discuss final feedback. "If everything goes well, my guess would be we're talking about sometime in March for the approval date for the standard," Smith said.

However, implementation of the CCR is up to the health care industry. "From everything I'm hearing, there are many physicians who are anxious to implement this standard in their work," said Smith.

Patients will benefit as well. "Informed patients are better patients," said David C. Kibbe, M.D., director of the AAFP's Center for Health Information Technology. "This is one route to self-management and an essential component of care coordination."

The final standard, available in an electronic or hard-copy format, will consist of a seven- to eight-page document and a spread sheet. ASTM members will be able to download the document free from the ASTM Web site. If you are not an ASTM member, the standard will be available for a small fee, probably less than $50, said Smith.

To read more about the CCR, go to http://www.aafp.org/x24962.xml on the AAFP's Web site. Click on the link to ASTM's Web site for additional details.

To reach writer Sheri Porter, e-mail sporter@aafp.org.

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AAFP supports concept Excitement grows about continuity-of-care record

AAFP supports concept
Excitement grows about continuity-of-care record