Curbside Consult with Dr. Jayne 3/25/19

Back in November 2017, the Epic-using world was abuzz about Share Everywhere, which was supposed to let the rest of us who are using other systems have one-time access to key patient information such as medication lists, problem lists, test results, allergies, and possibly physician notes. I remember from the announcements that the feature was version-dependent and figured it would take some time for the most current general release version to roll out to the various health systems that surround our independent urgent care.

Share Everywhere allows patients to generate an access code that allows the patient to give access to a provider, home health worker, therapist, or other member of the care team who doesn’t already have access to the patient’s Epic chart. It’s supposed to be accessible through MyChart. Since anyone in my city who has been hospitalized in the last year has been cared for on an Epic system, I figured a year would be enough for the hospitals to roll out the latest and greatest so that patients could let our urgent care providers peek behind the curtain at their records.

Now that flu season is starting to abate and I have a little more time to breathe while I’m talking with patients, I decided to make a concerted effort to ask patients about their use of MyChart in general and Share Everywhere in particular.

Patients frequently pull up information on medications, whether it’s from MyChart, the Walgreens app, or their CVS profiles. Some even access their pharmacy benefit manager, such as LDI or Express Scripts. Many patients still carry a paper copy of their medication list in their wallet, often with strike-outs and additions.

Today, I had four patients offer to pull up their account in MyChart. None of them had any knowledge about Share Everywhere or how to access it. I decided to go digging for it myself once I got home, accessing my account at Big University Hospital. Once I found the link at the bottom of a little-used tools menu, I generated a code for myself.

Despite having an accurate problem list in my patient-side account, the “share” version of my chart was lacking a problem list of any kind. It’s basically blank. The medication list contained a list of items that didn’t show any date of prescription or the name of the prescribing provider, only the person documenting it whose name I didn’t recognize. Only the items documented pre-Epic that came in with a conversion had start dates. Allergies were up to date (fortunately) but immunizations were blank. I found some useless test results that all said “see scanned report.” The family history information was clearly entered by the clinical geneticist I saw a while back, based on its specificity. There wasn’t any kind of a list of providers, which might be useful for patients that see a few more providers than the two I see each year.

Going back to MyChart, I also found a “Wallet Card” feature I had never seen before, which was supposed to have a “convenient, printable summary” of my medical information. The diagnosis list was blank, the medication list was blank, the allergies were blank, and it included a work phone number where I was last seen in 2007. I’m not sure how it’s even in the chart since I make sure to review the updates every time I’m seen at a practice, but it’s in there nevertheless. I found a handy way to print my eyeglasses and contact lens prescriptions, but unfortunately it doesn’t have my name on it or the name of the provider, so it’s not useful to try to get lenses dispensed. Good idea, poorly executed.

I’m a curious person and I was on a mission, but I wonder how many other people know these features are available to them or how to use them? Certainly Big University isn’t sending out an email telling patients that if they wind up at another place’s emergency department or an outside urgent care, here’s the best way for that competitor to access their records.

Now that I know how to tell patients how to find the Share Everywhere code generator, I’m at least able to go back to my desk and peruse their records without having to try to read them on a phone in the exam room. I’m not due to go back to Big University as a patient until at least July, so I’ll have to try to clean up the phone number issue at that point. I’ve learned from battling the billing team through the patient portal that it’s not worth trying to deal with it remotely. It hasn’t been effective in the past and I ultimately have to call a physical office.

We’re still a long was from patients being able to truly hold their records in the palms of their hands, but at least we’re taking baby steps. Maybe I’ll start a grassroots movement to have patients actually review their records and inundate the health systems with correction requests where needed. Depending on the volume, it might spur some changes in documentation habits or help providers understand that there are people outside their own system that are seeing what they are putting into charts. I’ll have to follow up with some of the more senior members of my family that have more extensive records and see what resemblance theirs bear to reality.

I’d be interested to hear from non-Epic providers whether they’ve had much utility with Share Everywhere and whether other hospitals and health systems are doing a better job keeping it accurate than mine is apparently doing. And from patients, are you aware how to generate a token for your providers to access your information? It’s only good for five minutes, so you have to do it right there, but in the right circumstances it would be useful. I’m also curious whether the other major software players have similar access for outside providers. If you can point me in the right direction, I’ll start polling patients. It’s got to be easier than watching people try to populate an intake form from memory.

When’s the last time you shared your record? Leave a comment or email me.

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