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Successful historic exam
Monroe Clinic medical assistant Sandy Quinn takes the blood pressure of volunteer patient Mark Donner on Monday. The live international reading of a patient chart between New Glarus and Donner's regular clinic in Canada was the first of its kind in the world. (Times photo: Bridget Cooke)
NEW GLARUS - A typical check-in at the Monroe Clinic in New Glarus was given a new twist Monday morning when three walk-in patients - two from The Netherlands and one from Canada - went through the motions of an average appointment with results simultaneously delivered to their countries of origin during a blood pressure reading in Wisconsin.

The live test run was the first of its kind in existence, according to the Clinic. No other organization in the world had previously run the live correspondence. Through the use of EpicCare, a software used by medical groups, community hospitals and academic facilities, the chance to sync medical care across borders was realized.

Mark Donner, one of the recipients of a blood pressure test, was a volunteer from Sault Ste. Marie in Ontario, Canada. As one of the formulators for the program in his community of just more than 70,000 people, he acknowledged the importance of synchronizing health information in order to ensure the best care possible for people who may not be in their neighborhood either during an emergency or when the need comes for a visit to a local clinic. Being close to the northern Michigan border, he cited day trips by local residents as examples.

Donner has seen the positive side of a higher use of technology through his position with the Group Health System, which has more than 80 separate care providers in six locations as well as 350 total employees, from nurses to support staff.

"In Canada, we have a lot of what we call "snowbirds' who go down to places like Arizona and Florida," Donner said. "The opportunity for them to be able to pop into a clinic and have their records available for the physicians down there is exciting. They might not know exactly what their health is like or what is in their records and this gives them immediate access to it so they can provide better care."

As Donner and fellow test subjects Gerwin Schaapman and Margaret Van Kester approached the clinic receptionists, they were asked to answer a series of questions similar to those requested in preparation of a general physical. From their birthdays to verification forms, the individuals filled in their information with little trouble, the rhythm skipping a beat when a difference in procedure occurred. One such instance was the discussion that followed a request for Schaapman to provide a telephone number, and then later when Donner pointed out it was unnecessary in his country to provide a social security number as identification. The three to be tested were then taken to different exam rooms where the nurse handling their care was able to produce an electronic chart of all medical information which had only been verified moments before by providers working in a clinic located in another country. Everyone was happy to see the operation went smoothly.

"It's nice to see this moving forward," Donner said. "I'm looking to forward to getting more people in the U.S. upgraded to the international version so we can start making it more useful for ourselves."

The purpose of the live international test was to set up the eventual practice of use in every clinic with the same software throughout the country. Since the use of the live program in 2003 by the Monroe Clinic network, facilities throughout the country have been tasked with a similar everyday practice and with the added utilization of Care Everywhere, a program which has allowed providers the technology to - with patients' consent - share health information securely amongst one another. So far, the program has spread out to 33 states and 63 organizations, which have amassed more than 100,000 chart transfers with the help of Epic.

To Chief Information Officer Carrie Blum, this event was the next step in the process of creating a more efficient network of care providers. The globalization effect on the medical world could allow a vacationing individual originally from a European country to be treated at a participating hospital within the United States, with the information at hand to be verified by the patient's doctor an ocean away. According to the Office of Travel and Tourism Industries, more than 7.7 million United States citizens had traveled out of the country in the month of June alone, with Europe, Canada and Mexico at the highest rates of travel destinations.

"As people travel more and more than they ever have, and international travel becomes more common, this is going to be a huge benefit to our patients," Blum said, speaking to the ways in which patients could positively utilize the technology. "Emergence, obviously, but even in normal care situations; all of these exchanges are going to improve health. It's very exciting to be able to do this."

Systems Application Specialist Jane Smith, designated as project manager, helped organize a majority of the planning for the practice run to take place. Carrying out plans for the moment in health care history had taken four total weeks; the time in which Care Everywhere International was taken to set up. Most of the preparation was dedicated to the readiness of workers within the clinic. Technical aspects were tested for any flaws as well.

Beforehand, the tools to provide services throughout the numerous states had been put in place in 2012.

Countries now currently working with the international system are The Netherlands, Canada, United Arab Emirates, the United Kingdom, Singapore, Australia and the United States. Facets of the system have been set up to accommodate language barriers and differences in procedure.

Though there are still few facilities in the participating countries currently operating the international program, groups hope to help expand the use of these methods as time goes on.