Since CHIME is not an EMR, the obvious question is whether CHIME can integrate with EMRs.

The short answer is yes, absolutely. Read more to learn about some of the details.

Via Automated REST API Upload

APIs are a way for software to communicate directly, in the background.

For organizations that have the capacity to implement an automated outgoing REST API post from their own systems, CHIME can be configured to receive appointment data.

The clinic will be provided an endpoint and API token to securely upload appointment date on a regular basis, on whatever schedule desired by the clinic. The exact format of the payload can be discussed and custom configured.

Who is this best for? Clinics who have direct access to their own patient and appointment data, and can configure an automated outgoing REST API call.

Note: Real-Time Appointment Status Syncing is not available with this option.

Without CHIME, most clinics use the EMR scheduling screen to monitor and communicate the status of individual appointments. For example, clinics that use OSCAR oftentimes change the status of the appointment to say that patients have arrived, or are in the room, etc.

Typically, with CHIME, this information is managed within CHIME instead. Once patients are checked-in, they will show up within CHIME and staff and clinicians use CHIME to know which patients have arrived, their status, etc.

Because this is a key aspect of what CHIME manages, the information captured and communicated is much more specific and includes arrival times, wait times, multiple step appointments, room information, waiting room information, etc.

To ensure a single “source of truth” and to ensure staff successfully “change over”, CHIME is designed to NOT update the appointment status within the EMR even when it’s possible from a technical point of view. Check-in information is captured and communicated only within CHIME because this is where all staff and clinicians will consistently be accessing this data.

Staff will be initially frustrated by this because it’s a change from the status quo, but in our experience, it’s the better long-term approach. Having this data in two spots usually creates long-term confusion and makes change management harder.

However, every clinic is unique and there may be specific situations where updating the appointment status within the EMR is highly desired, for any of these three reasons:

• to manually check patients in via the EMR, (instead of CHIME)

• to use a third-party kiosk, (instead of the CHIME kiosk)

• to view the status of patients within the EMR, (instead of CHIME)

If so, it is possible today to enable this feature for clinics using OSCAR and for clinics using Telus PS. It is likely not possible for other EMRs.

In short, no.

Even with EMR integration, the expectation and plan is that users will be using both their EMR as well as CHIME, on an going basis. EMR integration eliminates or minimizes certain manual steps which would otherwise be needed, but still using only the EMR, and “ignoring” CHIME, isn’t realistic.

Going forward, the EMR remains the key source of truth for the purpose of storing medical information, billing, and future appointment scheduling, but CHIME becomes the source of truth of the real-time status of the clinic such as the status of every clinician, the status of every patient, and the status of every room. This real-time knowledge is what gives CHIME it’s transformative power. CHIME is a technology that has been explicitly designed to solve problems different from the problems an EMR solves - its differences are what allows CHIME to solve problems EMRs typically can’t. This is one reason why many clinics will deploy additional dashboards, whether by giving staff multiple screens, and/or by wall-mounting them.

Depending on the exact nuances, there may be situations where occasional double entry remains necessary (i.e. a similar change is made in both the EMR and CHIME manually), as well as situations where something traditionally done within the EMR, must now be done within CHIME. Your CHIME account manager will work closely with you to evaluate and assess the necessary changes to your internal workflows, but trust us (and this detailed case study), it all works out. Change is hard, but some change is always necessary, and we’ve worked hard to identify key elements which make change achievable (such as the installation of room tablets).

Does EMR Integration Eliminate the Use of Two Systems?

In the absence of EMR integration entirely, patient appointments must be manually added into CHIME one by one, using templates.

Every type of EMR integration eliminates the need to do this step. Instead, what happens is that all of a particular days appointments automatically show up in the EMR, structured correctly for the type of appointment that it is.

This might sound simple, but this is actually tremendously complicated because CHIME needs to be properly configured to have the right workflow for every single type of appointment, everything from how the appointment should be checked in, to the language to use when announcing the patient’s name, to the clinicians that patient will see, in which order, where, to what happens after the clinician is done seeing the patient.

Not to worry though, this is a key part of what CHIME does for you, as part the setup and configuration process.

Additionally, if direct API access is available, other very specific pain points can be potentially addressed:

Reflecting Changes made in an EMR, in CHIME

These changes rely on direct API access because this requires near real-time access to EMR data. Even a 1 minute delay makes the following types of changes usually impractical.

• if an appointment is cancelled or deleted from the EMR, the corresponding scheduled appointment is cancelled or deleted from CHIME. This helps automatically eliminate clutter within CHIME.

• if an appointment is checked in within the EMR, the corresponding appointment is checked in within CHIME. This helps eliminate double entry in situations where changing the status within the EMR is critical.

• if an appointment is finished or billed in the EMR, the corresponding appointment is finished in CHIME. This helps streamline certain workflows or situations where a clinician might have missed checking out of a room.

Reflecting Changes made in CHIME, in an EMR

These changes rely on having write access via a direct API connection. This is the most complicated and difficult type of connection. In general, we do not recommend pursuing the following.

• if an appointment is checked in within CHIME, the corresponding scheduled appointment(s) within the EMR are updated.

• if an appointment is finished within CHIME, the corresponding scheduled appointment(s) within the EMR are updated.