HIT National Editor

Electronic medical records (EMRs) have generally been pitched as gathering, recording and storing a patient's medical history. But if hooked to the Internet, EMRs can have many more uses and offer a host of features and applications.

These are possibilities being developed by HealthPartners (Bloomington, Minnesota), demonstrating this versatility by using its EMR system to provide messages concerning the swine flu to more than 150,000 patients in its system.

Describing itself as "the largest consumer-governed, non-profit healthcare organization in the nation," HealthPartners says these 150,000-plus patients are those with online access to its system which provides them a variety of resources through a secure e-mail account and, now, information about the swine flu.

Authored by doctors of HealthPartners' Medical Group, the messages were geared to reflect the particular circumstances of HealthPartner's patients in Minnesota and nearby states.

As of mid-May, two of those messages had been posted on the system. And while this may not seem like a lot, given the flurry of interest in what was initially described as a global pandemic, Joe Dangor, communications consultant for HealthPartners, told HIT that the organization wanted "to make sure we push messages out quite judiciously, only health-related messages." And he judged the two messages as the only ones required by regional circumstances, suggesting an attempt to allay patient fears and avoid panic.

He said that the system was previously used to alert patients about drug recalls, and that the two alerts concerning the flu constituted "the next step" in use of the online system.

The first message noted "all the news" related to first reports of the swine flu and offered a link to the Centers for Disease Control and Prevention (CDC; Atlanta) offering "credible information," with advice to call the HealthPartners appointment line for discussion with a nurse concerning what to do about any unexplained aches, fever, sore throat or cough. The message also noted that there had been no cases of swine flu in Minnesota or neighboring states.

The second message passed along a judgment by the Minnesota Department of Health that the swine flu was "behaving very much like regular seasonal flu, in terms of the severity of illness people are experiencing." While saying that it was "less of a concern than first thought," the advisory recommended taking "steps to avoid it" and offered a link to "answers" concerning methods for protecting against the flu and common questions about it.

The Online Patient Services feature is described by HealthPartners as a service provided 24/7, offering interaction with their particular clinics and featuring: online test results (90% of results within 24 hours); access to medication lists; prescription refills; immunization records; appointment schedule; bill payment; and consultation with care providers.

Dangor said that those patients with the online access had provided "very positive feedback about these messages going out. Many people were aware of the media frenzy, and there were a lot of opportunities for misinformation. So they were very pleased to get a pro-active message from their care providers about what was going on and what steps to take.

Besides using an Internet system in this way, Dangor noted that the research division of HealthPartners, HealthPartners Research Foundation, was also a participant in a consortium of organizations established for early detection of bioterrorism events and that the consortium has since expanded its efforts into flu surveillance. That system was established in 2002 with a $1.2 million grant from the CDC, now run its course, the effort now being underwritten by the Minnesota Department of Health.

The HealthPartners researchers send information to the department of health each day concerning patient complaints and diagnosis codes that indicate what illnesses are most frequent.

The system searches for upper and lower respiratory illnesses, rashes, fevers, neurologic events, sepsis and health conditions that are indicators of bioterror agents and now those symptoms that best characterize the flu. The results are then compared to historical records to identify spikes and unusual clustering of revealing symptomologies.