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Secure and timely communication from local Emergency Room provides greater opportunity for medication management for clients at The Mental Health Center of Greater Manchester


As the need for mental health services and substance abuse treatment continue to rise in the state, timely communication from emergency rooms to those in the care team becomes increasingly important. That’s why the Mental Health Center of Greater Manchester looked to Elliot Hospital as their top priority when implementing their new integrated Direct secure messaging component in their electronic health record (EHR) system, NetSmart’s My Avatar.

While an electronic health information exchange (HIE) pathway was already established between the two organizations, The Mental Health Center wanted to move away from the less robust form of communication using a webmail system, which required them to log into a web-based portal to send and receive clinical information. They set a goal in 2016 to enhance the use of their EHR by implementing an integrated secure messaging solution directly through their EHR system. This new solution would allow patient information collected by other providers in the community to be utilized and incorporated into the patient chart so that the information is available at the point of care when needed most.

Supported by NHHIO through the Advance Interoperable Health Information Technology Services grant, The Mental Health Center and Elliot Hospital came together to discuss ways in which the new technology would allow them to improve care coordination as shared patients transition in to and out of the Emergency Room. The two organizations determined that the best way to communicate this information would be through a Transition of Care Summary, or CCD, which would allow The Mental Health Center to incorporate medications, allergies, diagnoses and care plans from the CCD sent by Elliot Hospital, directly into their EHR. “When one of our patients is seen in the ER, it’s vital that we receive notification especially if a medication was changed or newly prescribed,” says Heather Gagnon, EHR Director at The Mental Health Center of Greater Manchester. Gagnon continues, “Exchanging information provides us with up to date knowledge about our shared client that may be beneficial to treatment here, such as their emergency contact and their care team members.”

To ensure that the Transition of Care Summary (CCD) is sent consistently, Elliot Hospital implemented a system that would automatically send a CCD to The Mental Health Center within 8 hours of a shared clients discharge from the Emergency Room. The automated delivery of the CCD notifies The Mental Health Center when a client was seen and allows them an opportunity to reconcile medications that may have been updated or prescribed so that when the patient returns to our office, we have a timely account from the hospital. Gagnon continues, “Often times these clients are seen in our Emergency Services Department, so it is useful to have this clinical information to help them engage in treatment and work towards a shared care plan”. The Mental Health Center successfully transitioned to their integrated Direct secure messaging system in the Fall of 2016 and the initial pilot between them and Elliot Hospital is now complete. To further expand upon the success of sharing secure health information with Elliot Hospital, the Mental Health Center is now looking to other local hospitals and healthcare providers to implement HIE activities that work to serve their common patients. Robbie Cowette, EMR Administrator at The Mental Health Center of Greater Manchester states that she, “looks forward to expanding the use of the health information exchange and expects that is will have a positive impact on our practice and our clients as they transition between providers in the community for care.”

The Mental Health Center is one of eight Community Mental Health Centers in the State of NH receiving grant monies to expand the use of HIE. These funds are provided by the New Hampshire Health Information Organization (NHHIO), as part of the Advance Interoperable Health Information Technology Services to support the behavioral health and post-acute long-term care communities.

About The Mental Health Center of Greater Manchester: The Mental Health Center of Greater Manchester (MHCGM) is a private non-profit system of comprehensive mental health services that for more than 57 years has been available to New Hampshire citizens who experience problems with mental illness, often with co-occurring
substance abuse. MHCGM has 300+ employees operating over 30 programs, the largest provider of outpatient behavioral health services in New Hampshire, and is affiliated with the Department of Psychiatry at Dartmouth Medical School. Designated as the Community Mental Health Center for Region VII (greater Manchester) by the NH Bureau of Behavioral Health, MCHGM provides a broad range of services to 4,600 people who have a serious and/or persistent mental illness. This year alone MHCGM will serve over 11,000 individuals, including veterans and their families, some 800 seniors, and 2,000 children and adolescents. To learn more about The Mental Health Center of Greater Manchester, visit us at www.mhcgm.org/

About Elliot Health System: Elliot Health System is a non-profit organization serving the healthcare needs of the community since 1890. The largest provider of comprehensive healthcare services in Southern New Hampshire, Elliot Hospital, a 296-bed acute care facility and the first community hospital in the state, serves as the cornerstone of the health system. Elliot is home to Manchester’s designated Regional Trauma Center, Elliot Breast Health Center, Elliot Urgent Care, a Level 3 Newborn Intensive Care Unit, Elliot Physician Network, Elliot Regional Cancer Center, Elliot Senior Health Center, Visiting Nurse Association of Manchester and Southern New Hampshire, Elliot Health System / Dartmouth - Hitchcock 1-Day Surgery Center, Elliot Memory & Mobility Center, NH Arthritis Center, Elliot Retail Pharmacy, Elliot Medical Centers in Londonderry and Hooksett, and The Elliot at River’s Edge. For more information about any of Elliot’s services, call Elliot Direct at 603-663-1111 or visit www.elliothospital.org.

About the New Hampshire Health Information Organization (NHHIO): NHHIO Spotlights are stories from NHHIO members who use health information exchange to improve care coordination. NHHIO is a 501(c) 3 non-profit charitable trust organization whose mission is to securely connect healthcare communities to share patient health information needed for informed care decisions. We collaborate with hospitals, physicians, community health centers, long term care providers, home care providers and other clinicians involved in the delivery of healthcare. Our vision is to be New Hampshire’s trusted resource for health information exchange, improving quality, efficiency and patient safety while reducing healthcare costs. To learn more about NHHIO and its services, please visit us at www.nhhio.org

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