Many hospitals that are completing the early stages of adoption of remote second opinion (RSO) systems may now be thinking through the integration of this system with their downstream systems. Most of the work performed by RSOs is intentionally performed outside of the hospital's EHR, PACS, pathology, or other electronic clinical records storage systems. However, should a patient that receives a remote second opinion visit the hospital for a procedure or inpatient visit, these records will need to become part of the hospital's permanent patient file.

Advisory Board article: Learn where your organization fits on the
remote second opinion maturity model

Remote second opinion systems often cater to patients that are not yet included in the hospital’s patient roster. Often a second opinion is issued, from a legal perspective, as an opinion rather than a medical diagnosis or recommendation for treatment. This often requires second opinion records to be maintained separately, with remote recipients not considered a “patient” in a formal sense.

Transferring Records into Your Downstream System

However, with one of the goals of most remote second opinion programs to become the facility of choice for a second opinion patient seeking treatment, the next step toward systems integration will naturally become a consideration for a successful RSO program. Should the patient decide to request direct treatment from the second opinion rendering facility, then the records captured for that patient as well as the second opinion itself would likely need to be transferred to the core downstream systems for the hospital.

We encourage hospitals to consider the approach to integration that suits them best. These range from the least invasive and least costly method of uploading a patient’s medical records to the appropriate VNA and then manually ingesting them, to a more complex and expensive system that seamlessly interacts with a pre-set data flow to automatically tag each record of a second opinion with the patient’s local ID, and to route these to the appropriate system based upon the record type and content.

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Hospitals that integrate their second opinion systems with their downstream infrastructure often find the convenience of routing external patient records transcends their second opinion practice. Most patients that visit a hospital for treatment or care, whether an RSO or a more traditional inpatient, have prior records located in another medical records system. Since most of these systems are either incompatible or unconnected with those of the hospital, it can be challenging getting the priors into the patient’s file.

Modernizing the Process

Unfortunately, the standard method for transferring medical records amongst facilities is fax, photocopies, and CDs, all requiring a careful matching of externally generated records with different patient ID numbers to the receiving hospital’s systems. An electronic system that automatically matches received electronic files with local patient records is much more accurate and efficient. The hospital may also find it compelling to utilize the front end of the second opinion system, which collects prior patient records, as a virtual collection system for all arriving inpatients.

Either way, ultimately hospitals standing up second opinion practices should consider the benefits of integrating these RSO systems with their core downstream records storage systems for increased efficiency and streamlined operations.