Epic Care Everywhere

Traditionally thought of as "interoperability", Care Everywhere processes requests to and from other health systems that care for patients, sending standardized summaries (C-CDA), and incorporating the new data into patient records.  Information can be exchanged directly between standards compliant EHR systems or with the help of Health Information Exchanges (HIEs) and Health Information Service Providers (HISPs).

Care Everywhere helps ensure that clinicians have the information they need to treat patients, both for unplanned transitions of care, such as visits to the emergency department, and planned transitions of care, such as referrals.

If your organization uses Epic’s electronic health record (EHR), and has given you access to Care Everywhere, you can utilize this functionality to access clinical information from San Francisco Department of Public Health.  If you have another EHR, you can look for this information in your EHR's health information exchange viewer.

If you aren't sure, check with your organization’s EHR system team or IT department.

Care Everywhere exchanges information with organizations using industry standard transport protocols. In the query-based approach, Care Everywhere uses transactions from the XCA and XDS.b integration profiles developed by Integrating the Healthcare Enterprise (IHE). When sending or receiving information for planned transitions of care, Care Everywhere uses Direct Project standards.

The types of information exchanged by Care Everywhere follow HL7's Clinical Document Architecture (CDA) standards and are outlined in the next section. For a complete list of standards supported by Care Everywhere, refer to the Care Everywhere Supported Standards white paper.

When establishing an initial Care Everywhere link between SFDPH and another organization’s Epic EHR, you must be in an open encounter at your organization. The encounter type must be one that your organization has authorized for Care Everywhere querying (i.e., outpatient appointment, admission, or notes only encounter).

1. From the open encounter, navigate to your Care Everywhere activity (this may be displayed as an activity tab or found under the More button) then select Request Outside Records.
2. SFDPH may already be linked to your patient. If not, select Query New Organization, type San Francisco Department of Public Health, select it and enter your Epic password if prompted.
3. If a matching patient record is found, it appears. Demographic information is highlighted so that you can verify patient details before proceeding.  If a result isn’t an exact match, you might need to contact SFDPH.
   • If you 've found the correct patient, click “Yes ‐ Correct Patient”.
   • If the wrong patient appears, click “No ‐ Incorrect Patient”.
   • If no match is found, please call the SFDPH HIM Department at 628-206-8640, and press "0' for assistance.  Please request the patient’ s Care Everywhere ID and follow Epic prompts.
4. Now your patient is linked with San Francisco Department of Public Health!  You can access finalized SFDPH information such as clinical summaries, office visits and test results.
5. To request an update to your query results, navigate to your Care Everywhere activity and select Request Updates. SFDPH does not require that you be in an active encounter to perform an update. However, your organization may have this requirement.

Helpful Hints

• When opening an encounter available through Care Everywhere, you may need to click a hyperlink titled view related clinical summary… to view complete information.
• If your organization allows viewing linked patients through Chart Review, a Care Everywhere icon will appear designating linked information. Care Everywhere results can be toggled off and on using the Care Everywhere button.