Impact of Patient-Controlled Analgesia (PCA) Smart Pump-Electronic Health Record (EHR) Interoperability with Auto-Documentation on Chart Completion in a Community Hospital Setting

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Integrating smart pumps with an electronic health record (EHR) reduces medication errors by automating pump programming and EHR documentation. This study describes the patient safety and financial impact of pump-EHR interoperability at a community hospital. Methods A 316-bed community hospital in Sugar Land, TX, went live with pump-EHR interoperability in October 2019. Data were collected from April 1, 2019, to June 30, 2019 (before implementation) and from April 1, 2020, to June 30, 2020 (after implementation). Rates of drug library compliance, alert firing, alert override, override within 2 seconds, high-risk alert override, and alert resulting in pump reprogramming were measured. Financial impact was measured by Current Procedural Terminology code capture per kept appointment in the infusion center. Results Drug library compliance increased from 73.8% to 82.9% with pump-EHR interoperability (P < 0.001). Infusions generating alerts among all infusions programmed with the drug library decreased from 3.5% to 2.6% (P < 0.001), overridden alerts increased from 64.8% to 68.9% (P < 0.001), alerts overridden within 2 seconds decreased from 17.3% to 13.8% (P < 0.001), and reprogrammed alerts decreased from 20.7% to 18.3% (P = 0.002). Conclusion Pump-EHR interoperability leads to safer administration of intravenous medications based on improved drug library compliance and more accurate smart pump programming.

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Professional fission in medical routines: medical scribes and physicians in two US hospital departments

Journal of Professions and Organization ◽

10.1093/jpo/joaa023 ◽

2020 ◽

Author(s):

Ann L Bryan ◽

John C Lammers

Keyword(s):

Electronic Health Records ◽

Electronic Health Record ◽

Community Hospital ◽

Health Record ◽

Health Departments ◽

Health Records ◽

The Us ◽

Electronic Health ◽

Medical Scribes ◽

Digestive Health

Abstract In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US’ federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes’ roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians’ work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.

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COMPARISON OF A FRAILTY RISK SCORE AND COMORBIDITY FOR EARLY REHOSPITALIZATION USING ELECTRONIC HEALTH RECORD DATA

Innovation in Aging ◽

10.1093/geroni/igz038.3307 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S906-S906

Author(s):

Deborah A Lekan ◽

Thomas P McCoy ◽

Marjorie Jenkins ◽

Somya Mohanty ◽

Prashanti Manda

Keyword(s):

Electronic Health Record ◽

Average Length ◽

Laboratory Data ◽

Hospital Setting ◽

Adverse Outcomes ◽

Risk Scores ◽

Unplanned Readmission ◽

Health Record ◽

Electronic Health Record Data ◽

Electronic Health

Abstract Frailty is a clinical syndrome of impaired homeostasis and decreased physiologic reserve and resilience resulting in diminished ability to recover from stressors. In the hospital setting, barriers to adoption of popular frailty assessments make them impractical for widespread use. Improving quality and costs associated with hospitalization has motivated using data from the electronic health record (EHR) to identify patients at risk for adverse outcomes such as early readmission. Patient-level factors such as frailty and comorbidity may signal high readmission risk. In this retrospective study and secondary analysis of EHR data, we investigated Frailty Risk Scores (FRS) in models that included sociodemographic, comorbidity, and laboratory data for early 3-, 7-, and 30-day unplanned readmission. Study data were collected from a health system in the Southeastern U.S. on adults >50 years with an inpatient stay of >24 hours, 2013-2017. Exclusions included planned readmission and in-hospital mortality. The FRS was constructed using ICD-10-CM codes mapped for symptoms, syndromes, and laboratory values. Cox and logistic regression were conducted to examine associations with readmission. Area under the receiver operating characteristic curve (AUC) quantified accuracy. The sample was 53% female and 73% non-Hispanic White (N=55,778). About one-third took at least 7 prescribed medications (34%) and average length of stay was 4.3 days (max=103.6). FRS was a significant predictor of readmission for almost all models, independently of three comorbidity indices (range AUC=.850-.854 for 3-day, .809-.813 for 7-day, and .757 to .768 for 30-day). Frailty and comorbidity are independently associated with early rehospitalization.

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The Patient Perception of the Nurse-Patient Relationship When Nurses Utilize an Electronic Health Record Within a Hospital Setting

CIN Computers Informatics Nursing ◽

10.1097/cin.0000000000000014 ◽

2013 ◽

Vol 31 (12) ◽

pp. 596-604 ◽

Cited By ~ 4

Author(s):

BETH STRAUSS

Keyword(s):

Electronic Health Record ◽

Hospital Setting ◽

Patient Perception ◽

Health Record ◽

Patient Relationship ◽

Electronic Health

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Extraction of Electronic Health Record Data in a Hospital Setting: Comparison of Automatic and Semi‐Automatic Methods Using Anti‐ TNF Therapy as Model

Basic & Clinical Pharmacology & Toxicology ◽

10.1111/bcpt.12055 ◽

2013 ◽

Vol 112 (6) ◽

pp. 392-400 ◽

Cited By ~ 14

Author(s):

Thomas Cars ◽

Björn Wettermark ◽

Rickard E. Malmström ◽

Gunnar Ekeving ◽

Bo Vikström ◽

...

Keyword(s):

Electronic Health Record ◽

Hospital Setting ◽

Health Record ◽

Electronic Health Record Data ◽

Record Data ◽

Automatic Methods ◽

Electronic Health

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THE EVALUATION OF ELECTRONIC HEALTH RECORD ADOPTION AMONG HEALTH PROFESSIONALS IN HOSPITAL SETTING

Jukema (Jurnal Kesehatan Masyarakat Aceh) ◽

10.37598/jukema.v7i1.1068 ◽

2021 ◽

Vol 7 (1) ◽

pp. 69-75

Author(s):

Riza Septiani ◽

Tiara Mairani

Keyword(s):

Health Professional ◽

Electronic Health Record ◽

Health Professionals ◽

Hospital Setting ◽

Health Staff ◽

Health Record ◽

End User ◽

Healthcare Settings ◽

Electronic Health ◽

It Skills

Background: Electronic Health Record (EHR) utilization has been improved nowadays and it is believed that the adoption of Information Technology (IT) that has been implemented in various setting may also accelerate qualified implementation in health care setting. This study aimed to evaluate EHR utilization in various settings by systemic literature review. Methods: systemic literature research was conducted with keywords “(evaluat* model OR evaluat* framework) AND (health professional* OR health staff*) AND (electronic health record OR EHR) AND (us* OR engagement OR implementation OR adoption) AND hospital”. Result: 833 literatures found at the beginning of literature search, after apply limitations, remove duplicates and exclude of irrelevant literatures, finally total 7 articles were included in the review. Conclusion: there are benefits and drawbacks of EHR utilization among health professional in different healthcare settings in some countries that included in this review. Some health professionals had positive experience of using EHR that its use can improve clinicians’ involvement, better clinicians’ representation and decrease workload. Meanwhile, others had different views that EHR use are ineffectiveness due to inability of the systems to meet users’ need, poor integration with existing workflows, poor IT skills among users and limited resources and training of EHR. Recommendation: Therefore, it is important to improve better design of EHR system with customized functionalities so it could improve the implementation and adoption of EHR by health professionals as end user.

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Investigating multiple sources of data for smart infusion pump and electronic health record interoperability

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa115 ◽

2020 ◽

Vol 77 (17) ◽

pp. 1417-1423

Author(s):

Kathryn K Marwitz ◽

Andrew C Fritschle ◽

Vivek Trivedi ◽

Matthew L Covert ◽

Todd A Walroth ◽

...

Keyword(s):

Electronic Health Record ◽

Infusion Pump ◽

Health Record ◽

Collaborative Partnerships ◽

Multiple Sources ◽

Data Repositories ◽

Usable Information ◽

Healthcare Engineering ◽

Electronic Health ◽

Smart Pump

Abstract Purpose Infusion pump data, which describe compliance to dose-error reduction software among other metrics, are retrievable from infusion pump vendor software, electronic health record (EHR) systems, and regional and national data repositories such as the Regenstrief National Center for Medical Device Informatics (REMEDI). Smart infusion pump and EHR interoperability has added to the granularity and complexity of data collected, and clinicians are challenged with efficiently comprehending and interpreting the data and reports available. Summary Collaborative partnerships between the Indianapolis Coalition for Patient Safety and the Regenstrief Center for Healthcare Engineering allowed for clinicians, informaticists, researchers, and engineers to compare the information gained and strengths of using smart infusion pumps, EHR, and REMEDI to assess hospital medication safety in a setting of interoperability. Seven reporting capabilities were used to compare available reports, and 2 hypothetical scenarios were developed to highlight these processes. Infusion pump vendor–provided software and reports were found to provide the most usable information for detailed infusion reporting, while the EHR was strongly usable for interoperability compliance and REMEDI excelled in benchmarking capabilities. Conclusion While infusion analytics needs may differ across health systems, a better understanding of the strengths of infusion pump data and EHR data may help provide structure and direction in the infusion analytics process. Infusion data repositories such as REMEDI are useful tools to obtain information in a way not delivered by smart pump data.

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