Finding outside or difficult-to-find records in UVMHN’s Epic and outside of Epic.

Here’s my approach as someone who practices at UVMMC, within the UVMHN.

CareEverywhere to find records in outside/non-UVMHN Epic and *also* outside non-Epic EMRs

Epic’s CareEverywhere works well with other hospital’s Epic implementations. Regionally, that means Dartmouth and the MGH/BWH/Partner’s network in Boston. (Lahey/BIDMC is switching to Epic soon as well.) In the 2020s, it has started working with non-Epic shops as well, including Community Health Center of Burlington. Many of these non-Epic shops are vendors for 15,000+ clinics and medical centers (eg, athenahealth, surescript, nextgen, particlehealth), so linking with these vendors will ping a broad array of clinics across the country. You need to link outside clinics and hospitals within CareEverywhere as a one-time step for each patient. I never assume that this linkage step was done because it usually isn’t.

To do a linkage, in CareEverywhere, click the little “e” next to the patient’s name in the left hand column or under the tabs (eg chart review, results) –> ‘Request Outside Records’. This might be hidden under ‘Rarely Used’. Once there, click the link that says ‘Find Outside Charts’. High-yield linkages to try are below. Bonus: click the star next to the names of these so they’ll show up as a favorite and you don’t have to search for them in other records!

  • Community Health Center of Burlington, inc – by searching “Community Health Center of Burlington”
    • Note: CHCB is sometimes listed as using NextGen or ParticleHealth, which you’ll see below. I usually ping them directly because one of those two vendors doesn’t work and I can’t remember which one it is.
  • Practices using athenahealth EHR – by searching “athenahealth” (not aetna, it’s like the Greek goddess Athena)
    • Note: This is what the private cardiology group in Timber Lane uses
  • Surescripts record locator gateway – by searching “surescripts”
    • Note: This is what the private OB group in Tilley uses
  • NextGen Share – by searching “nextgen”
  • ParticleHealth – By searching “particlehealth”.
  • Vermont Information Technology Leaders – aka VITL, which as of 2/2024 is broken (see the separate VITL section below) by searching “Vermont Information Technology Leaders”
  • Dartmouth Health – by searching “dartmouth”
  • Mass General Brigham – aka Partners by searching “mass general”
  • PRIMARY CARE HEALTH PARTNERS – a consortia of pediatric and adult primary care practices headquartered in Williston, search “primary care health partners”
  • Veterans Affairs/Department of Defense Joint HIE – aka the VA. Search “Veterans Affairs”.
  • A few regional hospitals to consider, based upon where they live:
    • Northwest Medical Center
    • Northeastern Vermont Regional Hospital
    • Rutland Regional Medical Center

For outside Epics: Finding information on CareEverywhere is pretty straightforward for other sites using Epic. In fact as of 2024, I’ve noticed that outside notes show up in-line with our notes in Chart Review! Super cool.

For non-Epic EMRs: There is usually one really ugly note from each group called “Summarization of episode note” or something like that in CareEverywhere –> Documents. These summarization notes are basically a snapshot of the entire medical record of these non-Epic linkages! Take a look: You’ll find labs, vitals, problem lists, notes, radiology reports, etc. They are unwieldy and usually ugly, but have lots of good info included. Keep scrolling all the way to the bottom.

Again, as of 2/2024, VITL’s CareEverywhere linkage is broken so those summarization notes for VITL don’t populate with anything useful.

VITL, aka VT’s HIE – An outstanding resource

The Vermont Information Technology Leaders (VITL) service is our regional health information exchange (HIE) for the state of VT and provides near real-time summary of notes, labs, radiology, etc from the state of Vermont. I can’t overstate how incredible this service is, especially getting outside hospital records and structured data from patients transferred from non-UVMHN hospitals in VT (eg NWMC, RRMC, NEVRH). Here’s the login:

Unfortunately, as of 2/2024, you need a separate login to get into VITL — it’s not a ‘single click’ from within Epic like HIXNY (see below). To get an account, please email with (1) name, (2) email address, and (3) location/department that the person works. I guess in theory you can do this for entire departments all at once. The VITL folks then apparently reach out to a Trained Security Officer within UVMHN (Jennifer Parks, the chief compliance officer) who verifies things and then VITL folks will grant access. I’m guessing you then get an email to set up an account afterwards. (Perhaps cc Jennifer Parks in the initial email to the vhiesupport email to expedite things? Who knows. Seems like it would save a step.)

Anyway, nearly everything of value within VITL exists within the All Results tab in their web portal. This includes notes, labs, radiology reports, etc. If you poke around in other tabs, you’ll find problem lists, medication lists, billing codes, etc. But the best bang-for-the-buck is in the All Results tab.


HIXNY is New York’s HIE (well, it looks like it’s the eastern part of NY north of NYC per the map here). You can find it under epic –> chart review –> encounters –> HIXNY (one of the buttons at the top next to Epiphany). This will pop up HIXNY is a separate window. Whether a patient is included is a bit hit-or-miss as I guess it’s an opt in for patients? I’ve had pretty good luck with patients having active accounts if they are middle aged or a senior. I bet that primary care practices across the lake must have some mechanism to get patients signed up HIXNY as part of their care. It looks like there is some sort of consent form that institutions can have patients complete. I’m not sure that UVMHN is actively having patients complete this form.

For patients with active HIXNY accounts, it’s outstanding. You can find all sorts of records, labs, radiology, etc. Per the HIXNY website, there is a functionality to access HIXNY data for patents without accounts/who have yet to provide consent in cases of emergency (aka “break the glass”). I haven’t figured out how to do this “break the glass” within HIXNY, but I haven’t been in a situation where I needed HIXNY access during an emergency.

Legacy Chart, aka pre-Epic, “old records” from hospitals in UVMHN

When UVMHN brought other hospitals into the network, it saved much of the scanned/dictated prior records in this funny app linked within in Epic called ‘Legacy Chart’. This is very helpful for finding old records from Porter, CVMC, CVPH, Etown, Ti, etc. You will find it next to the HIXNY and Epiphany buttons under epic –> chart review –> encounters –> Legacy Chart. When you click on it, it will pull open this weird file structure (if there are old records to be found). I’ve found critical information from old echocardiograms, colonoscopies/endoscopies, PFTs, op notes, consult notes, H&Ps, etc that has changed management.

Pre-Epic notes using a Notes Filter

This isn’t a setting or linkage as much as it is setting filters strategically within Epic’s Chart Review –> Notes tab to pull up things from the pre-Epic time (Epic turned on 10/2010). Before Epic there was our super old EMR called HISSPROD and later a pseudo EMR called Maple. Lots of HISSPROD discharge summaries and notes from Maple were brought into Epic.

When you are in a patient’s chart who had lots of care pre-2010, you can build this filter. (You unfortunately can’t build this filter unless old notes of the below type exist since they won’t appear as filter options.) Go to epic –> chart review –> notes –> filters –> type then select as many of these as appear:

  • Amb Consult
  • Amb Eval
  • Amb General Summary
  • Amb Letter
  • Amb Procedure
  • Amb Progress Note
  • Brief Procedure Op Note
  • Clinical Progress Notes
  • Communications
  • Emergency Room Record
  • H&P – (this unfortunately also will give recent H&Ps, but also gives old H&Ps, back then called ‘History and Physical’)
  • HISSPROD Discharge Summary
  • Op Procedure Note
  • Update Letter

You might need to try to build this shortcut in a few separate patients with pre-Epic documents. The list above will (mostly) pull in records from pre-Epic times.