As an emergency medicine resident at Maimonides Medical Center, I quickly recognized that communication between emergency physicians, primary care physicians, and specialists was at times disorganized. Partly due to patient non-compliance and untimely follow-up with primary care physicians and specialists and partly due to the chaotic nature of the emergency department, there is oftentimes a breakdown in communicating a patient’s history, presentation, and diagnosis with other physicians to further their care.
Lack of timely and informative communication becomes a matter of patient safety, coordination of care, and optimal resource usage. To that effect, I created a stateful service using Perl, CPAN, and Microsoft SQL Server (but is database agnostic) to send automated and directed internal emails to physicians within the hospital system.
Due to the stateful nature of the system, we are able to contextualize the patient’s care in the emergency department and apply dynamic rules to coordinate their care through various programs including congestive heart failure and total care management and utilize outpatient resources in the form of case management and social work.
While the emergency department initiated this project, we have observed adoption from most specialties including internal medicine, ob/gyn, general surgery, and cardiology. More often that not, physicians will only contact the emergency department when they have not received emails regarding their patient’s emergency department encounter.