Need a phlebotomy in Flanders? When providers can electronically call up a patient’s medical history, effective treatment is more likely to follow. Above: Tucson Medical Center’s health information management department.

James S. Wood / Arizona Daily Star 2009

A Tucson nonprofit is integrating with a Phoenix group to improve and expand the way electronic medical records are used in Arizona.

The partnership means the Tucson-based Health Information Network of Arizona, created in 2010, is formally affiliating with the nonprofit Phoenix-based Arizona Health-e Connection, which formed in 2007. The group will operate under the umbrella of the Arizona Health-e Connection.

All staff workers will officially be employed by Arizona Health-e Connection and the offices for both organizations will now work out of Phoenix.

The effort, expected to employ 20 full-time employees, is intended to be a more efficient way of reaching a goal of interfacing various patient medical record systems across the state. That means medical providers around the country and possibly eventually even the globe would be able to electronically access the individual health records of consenting Arizonans.

“We may still have some team members that work in different parts of the state telecommuting,” said Melissa Kotrys, who is the CEO of both organizations. “Frankly in the past there has been growing confusion throughout the community as to which organization does what, where people are supposed to go for what type of services.”

The real impact to Arizonans is expected to be improvements at the point of care as the network expands and has more participation between hospitals, community health centers and health providers.

Ideally that means a Tucsonan who has a heart attack in Italy or who suffers strokelike symptoms in Flagstaff will have less chance of going through unnecessary testing or getting prescribed medication that could harm them. That’s because their complete medical history, including lab tests, diagnoses and emergency-room visits, would be available to the providers treating them, increasing the probability of a more accurate diagnosis and effective treatment, too.

“In Arizona we have a law where patients whose providers participate with the network have the ability to opt out of participating,” Kotrys said. “They have a choice as to whether their information flows through the network.”

Kotrys stressed that the sharing of patient information is in a “secure and appropriate way.” Among entities already sharing information is El Rio Community Health Center and the Carondelet Health Network.

Both health information organizations have been working to help providers convert from paper to electronic health records. That percentage was once quite low — only 10 to 15 percent of doctors in Pima County were computerized in 2008, the Pima County Medical Society reported at the time.

About half of local doctors now maintain electronic patient records, estimated Steve Nash,  executive director of the Tucson Osteopathic Medical Foundation and former executive director of the Pima County Medical Society. Hospitals, labs and community clinics have also been getting more technologically savvy by swapping paper records for digital.

The problem is that not all of those entities have the same software for maintaining the records. There are numerous systems, including Epic, NextGen, Allscripts and Practice Fusion, among others, and they don’t talk to one another. That’s where the health information exchange comes in.

“In the next 15 months health information should be going back and forth in a timely manner when you need it, especially in the emergency room,” Nash said. “At some point mental-health records will be included. It is going to be a great thing. ... It will put everything in one place instead of having two closely allied groups.”

The advantage to medical providers is having all of a patient’s information at their fingertips provides more time for treatment and less for manually collecting patient history.

“We have a lot of data right now flowing into the system. We’ll be focusing on getting doctors, providers and hospitals using the data,” Kotrys said. “We have information on more than 3.5 million unique patients but the user base is what we’ll be growing.”

While it would be a lot easier if providers all used the same electronic health records software, it’s not the way the industry has gone. Kotrys estimates there are hundreds of different systems and a large number of vendors in the market.

“The industry has seen significant growth actually in different types of systems, ever since Medicare and Medicaid have been offering incentive payments (for adopting electronic health records),” she said.

Integrating multiple systems onto one network remains a constant challenge.

“Some of the systems are very small and homegrown. But there are certification standards nationally and as long as these companies can continue to meet the certification standards then there continue to be a large number of vendors,” she said.

“We need to address the issues of the ability of different vendors to abide by the same standards ... at this point in the game I don’t think we’re going to revert to just one system.”

Contact reporter Stephanie Innes at