Floating Hospital at Tufts Medical Center Implements HIE to Accelerate Transitions of Care of Prenatal Patients from Lowell General Hospital

Floating Hospital for Children is a full-service pediatric hospital at Tufts Medical Center. Their mission is to improve the lives of children and their families. Floating Hospital has affiliations with many community hospitals, allowing patients to seek care in their own communities without needing to travel into Boston. Tufts Medical Center is a member of Wellforce, a health system that also includes Lowell General Hospital and MelroseWakefield Healthcare. Tufts MC also has clinical partnerships with Cape Cod Hospital, MetroWest Medical Center and Lawrence General Hospital.

Lowell General Hospital, a Circle Health affiliate, is a not-for-profit community hospital that serves the Greater Lowell area and surrounding communities. The hospital has two primary campuses in Lowell, and is committed to maintaining the values of compassion, excellence, dedication, and integrity in their mission to provide excellent care for all patients. Lowell General’s Maternal Fetal Medicine team works in collaboration with Tufts Medical Center and Floating Hospital for Children to provide in- and outpatient counseling and diagnostic services, including ultrasounds and diagnostic procedures as well as genetic counseling and counseling for issues related to high-risk pregnancies.

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Tufts MC needs to be able to communicate directly and securely with each of their affiliate hospitals during transitions of care. Each hospital has its own electronic health record (EHR) system with distinct patient records. In the past, Tufts MC and its affiliate hospitals needed to fax each other relevant records during transitions of care. As faxes can sometimes distort images, this made interpreting records that include graphs or pictures difficult. Particularly in emergency situations, this manual process could be too slow and time consuming.


To improve their transitions of care, Floating Hospital implemented a new workflow incorporating health information exchange (HIE) to improve the continuity of excellent patient care without interruption. Their HIE implementation includes functionality based on Mass HIway Direct Messaging, including a Connect Device at Tufts MC to receive the messages. This new workflow was piloted with Lowell General Hospital’s Maternal Fetal Medicine Department.

At Lowell General Hospital, prenatal providers monitor how a baby’s heart rate reacts to each uterine contraction during labor and delivery. This results in a Fetal Link Report. If the report shows anything of concern, the providers send the report to Floating Hospital for Children for review and to determine whether the patient needs to be transferred for more intensive care.


With the new HIE-based workflow, the prenatal providers at Lowell General can send a Direct Message with a PDF of a Fetal Link Report directly from their Cerner Millennium EHR to Tufts Medical Center via the Mass HIway. The Direct Message is received by the Mass HIway’s Connect Device at Tufts Medical Center and is placed on a secure file share inside Labor, Delivery and Recovery Coverage for review.  A notification is sent via pager to the Labor and Delivery On-Call Resident.

A care provider at Floating Hospital reviews the report and follows-up with the care providers at Lowell General Hospital.



Tufts Medical Center began implementing the new workflow in 2019, and the feed went live between Tufts MC and Lowell General on September 4, 2019.


The bidirectional communication over the Mass HIway has significantly improved the speed and clarity of information exchange between Tufts MC and Lowell General Hospital, enhancing the continuity of care for their patients during labor and delivery emergencies. By transitioning to this bidirectional electronic exchange, providers at both hospitals have been able to better coordinate the care of these shared patients and better monitor potential health concerns of both the mother and baby.