North Shore Community Health Center Uses HAUS Services to Streamline Referral and Document Exchange

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North Shore Community Health (NSCH) is comprised of three family practice sites providing medical, dental, and behavioral health services to community members of all ages with a discounted and sliding fee scale based on family size and income. No one seeking care is turned away because of an inability to pay. In addition, NSCH offers multiple school-based health centers that provide medical and behavioral health services to students.

Sports Medicine North is a specialized care organization providing treatment for bone, joint, and muscle injuries and services such as sports medicine, pain management, and trauma. Their goal is to offer exceptional care to patients in the North Shore community enabling individuals to return to their healthy and active lifestyles.

Assistance from HAUS

In 2018, NSCH approached the Mass HIway, the Massachusetts Health Information Exchange, to provide HIway Adoption and Utilization Support (HAUS) services to aid them in improving the process of exchanging relevant medical information with their trading partners. Sports Medicine North agreed to work with NSCH to develop a more streamlined workflow that would allow them to more readily share documents and patient data.

HAUS Services assisted NSCH by:

  • Providing an introductory phone call to assess the technical situation at each organization, exchanging Direct messaging addresses, and outlining the project;
  • Coordinating periodic status update calls to keep the project moving; and
  • Coordinating testing calls using Webex to ensure that messages were sent and received, and confirming that the documents sent in the messages could be loaded into patient records and displayed to the provider.

NSCH desired to establish a connection with trading partners to securely exchange patient health information. A significant challenge NSCH ran into, in trying to facilitate the exchange of information, was locating partners who were willing and able to establish a connection. The HIway and HAUS were able to coordinate and connect NSCH with trading partners and assisted throughout the entire project until it was confirmed that information could be sent bi-directionally. Thanks to Joe Kynoch and his team for a successful project!” 

-- Andrea Russano, Director of Decision Support


NSCH and Sports Medicine North often need to exchange referral and progress notes between organizations. At each organization, an administrator would receive referrals and progress notes via fax, identify the patient, scan the fax, and attach it to the correct patient’s records.
Because the process was not automated, there could be a significant delay in important information being shared between providers. This led to delays in patient care as well as delays in closing the referral loop, driving both organizations to search for ways to improve the process.


When the organizations determined automating the process was a viable solution, they contacted the HIway to provide HAUS services to help facilitate the process for two specific functions: outbound referrals sent from NSCH to Sports Medicine North and inbound progress notes sent from Sports Medicine North to NSCH. Both organizations wanted to completely transition from physically sending documents to relying solely on electronic methods instead. With HAUS’ assistance, these organizations were able to eliminate faxing and send documents using secure Direct Messaging. Now, when NSCH refers a patient to Sports Medicine North, the clinician exports an .XML or .RTF version of the transition of care and clinical summary documents and sends it using the GE Direct Messaging feature in their EHR. Sports Medicine North receives the referral in their Direct Messaging mailbox and either creates a registration for a new patient and attaches the referral, or attaches the referral to an existing patient.

When Sports Medicine North needs to send progress notes back to NSCH, they produce an .XML of the Clinical Care Document or .RTF of the progress notes after documenting the patient services in their EHR and, using the Direct Messaging feature of their EHR, send the data back to NSCH who will then attach the notes to the correct patient’s records.

Cutting out the need to fax notes and referrals allows clinicians to receive patient information quicker and eliminates the need for an administrator to physically look up the correct patient and enter the information received by fax.


NSCH contacted the HIway in November 2018 to request more information on HAUS services, with the goal of starting the project in January 2019. Between November and January, MeHI and NSCH held an introductory phone call and began exploring potential trading partners.

Sports Medicine North signed on to the project in January and began working with their EHR vendor in February to resolve error messages and other complications when attempting to save exchanged documents.
Implementation took place between January and March 2019 with NSCH, Sports Medicine North, and the HIway maintaining regular contact as they reviewed the status of the project and tested the exchanges of electronic documents. On March 26, 2019, both organizations went live with the electronic exchange.


A significant portion of NSCH’s weekly referrals are sent to Sports Medicine North. NSCH estimates that they send roughly 50 referrals per week via the new workflow, and in return receive approximately 10 notes back from Sports Medicine North. Though faxes have continued to be sent from Sports Medicine North to NSCH in addition to the electronic exchange, these are redundant copies while the organization acclimates to the new workflow, and Sports Medicine North intends to eliminate the duplicate faxes moving forward. Eliminating the need to manually enter data from the faxed documents has reduced the time NSCH physicians need to spend copying information, which has improved patient care and lessened the risk of any typing errors.

HAUS Services

The free-of-charge HAUS Services program assists partnering healthcare organizations in the implementation of Health Information Exchange (HIE) to improve their care coordination process. The Mass HIway contracted MeHI, the Massachusetts eHealth Institute, to provide HIway Account Managers and other resources needed to deliver these services. The Account Managers will work with organizations to incorporate or improve the use of HIE through the development of use cases. HAUS offers three options for organizations to participate:

  • HAUS for MassHealth Accountable Care Organizations (ACOs), Community Partners (CPs), and Community Service Agencies (CSAs),
  • HAUS for healthcare organizations that need to meet the HIway Connection Requirements per the Mass HIway Regulations (101 CMR 20.00), and
  • HAUS for healthcare organizations that want to use Direct Messaging to support care coordination between healthcare providers.

If your organization falls into one of these three categories, you are eligible to receive HAUS Services free of charge. To learn more, click here.

If your organization is interested in using the free HAUS Services please email the Mass HIway at Include the word "HAUS" in the subject line, and include the following details in the body: your name, title, phone number, email address, and the name of your organization.