Digital Discharge - Clalit Health Services

Project's objective

Easing the patient's journey from the hospital to the community and home.
Transforming free-text recommendations written by the discharging hospital physician into structured, coded recommendations for continued care.
Establishing a unified clinical language for healthcare providers.
Ensuring easy and efficient access to medical information for both patients and community physicians.
Reducing the administrative workload for community physicians.
Aligning discharge recommendations between the two medical records.
Creating a foundation for receiving recommendations for Clalit-insured patients from other hospitals and transferring recommendations for Clalit hospital patients to other insurers.

About the Project

Upon discharge from the hospital, patients receive a summary letter from the discharging physician, which contains extensive information and instructions that are not always clear to them. This informational overload requires interpretation and guidance.

Typically, the patient consults their community physician for follow-up care. However, since the community physician uses a different electronic medical record (EMR) system than the hospital physician, they must read the printed letter, adapt the discharge instructions, and manually enter them into their system. This process increases workload, lengthens the patient’s visit, and may result in clinical misinterpretations. Additionally, the complexity and lack of alignment often frustrate both the physician and the patient.

In some cases, patients disengage from the process and fail to follow the recommendations given at the hospital, disrupting the continuum of care and, in some instances, compromising the quality of medical service provided.

Solution:

Establishing unified recommendations repository - A cross-platform repository shared by all Clalit healthcare providers will store structured recommendations from the Chameleon EMR system (used in hospitals). Community systems, such as Clicks (used in clinics), and the Clalit app for patients, will query and update this repository.
Enhancements in Chameleon - We developed six structured components that include: Diagnoses, Recommended medications, Laboratory tests, Consultations and procedures, Clinical course discussion and Recommendations.
Automated referrals in Clicks - Automatic generation of referrals for required tests in the Clicks system.
New functionality in Clicks - Community physicians will have access to structured hospital recommendations for patients. With a single click, they can approve or decline these recommendations, streamlining the workflow.
Discharge summary in the Clalit app - A new discharge summary screen in the app will clearly present the instructions and treatments prescribed by the hospital physician, ensuring patients can easily access and understand them.
Integration and standardization using FHIR - All data exchanges, interfaces, and coding comply with the FHIR data structure standard, enabling seamless interoperability and improving care continuity.