Safe Interorganizational Health Information Exchange During the COVID-19 Pandemic.

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Accurate and timely transmission of medical records between skilled nursing facilities and acute care settings has been logistically problematic. Often people are sent to the hospital with a packet of paper records, which is easily misplaced. The COVID-19 pandemic has further magnified this problem by the possibility of viral transmission via fomites. To protect themselves, staff and providers were donning personal protective equipment to review paper records, which was time-consuming and wasteful. We describe an innovative process developed by a team of hospital leadership, members of a local collaborative of skilled nursing facilities, and leadership of this collaborative group, to address this problem. Many possible solutions were suggested and reviewed. We describe the reasons for selecting our final document transfer process and how it was implemented. The critical success factors are also delineated. Other health systems and collaborative groups of skilled nursing facilities may benefit from implementing similar processes.





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Wong, Serena P, Heather N Jacobson, Jennifer Massengill, Heidi K White and Mamata Yanamadala (2020). Safe Interorganizational Health Information Exchange During the COVID-19 Pandemic. Journal of the American Medical Directors Association, 21(12). pp. 1808–1810. 10.1016/j.jamda.2020.10.022 Retrieved from

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Serena P Wong

Assistant Professor of Medicine

Heidi Kay White

Professor of Medicine

Dr. White's clinical expertise involves the care of older adults, especially care transitions, long-term care, and post-acute care.  She services as the Vice-Chief of Clinical Affairs in the Geriatrics Division At Duke University.  She has worked with peer faculty to develop clinical programs including Peri-operative Optimization of Senior Health (POSH) and Health Optimization Program for Elders (HOPE) which is a transitional care program from the hospital to skilled nursing facilities.  She serves as geriatrics medical director for Duke Population Health Management Office.  She is a member of the Executive steering committee for the Duke University Health System Geriatrics Operational Plan.  She is the medical director of Croasdaile Village Retirement Community.  Her educational activities include bedside teaching in the hospital, clinic and nursing home with geriatrics fellows, residents, medical students and other professional students such as nurse practitioner, and physician assistant. She co-directs the Advanced Course in Long-Term Care for an interprofessional group of learners.  She is a past President of AMDA The Society for Post-Acute and Long-Term Care Medicine.  She has worked to develop competencies for practitioners in this environment and developed online educational modules.  Dr. White’s research focuses on the general medical care of older adults with cognitive impairment. She has studied the nutritional decline and weight loss that often accompanies Alzheimer’s disease. In collaboration with Edward Levin, PhD, Associate Professor in the Department of Psychiatry, she has explored the cognitive effects of nicotine transdermal patches in older adults with varying degrees of cognitive impairment. Other work includes studying the effects of personalized music in older adults with dementia and implementing personalized music programs for pain and delirium relief in hospital and dementia care in nursing homes and assisted living facilities.  Current work focuses on clinical program development and sustainability.

keywords: cognitive impairment, Alzheimer's disease, weight loss, nutrition, nicotine


Mamata Yanamadala

Associate Professor of Medicine

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