Top ten challenges when interfacing a laboratory information system to an electronic health record: Experience at a large academic medical center

2017 ◽  
Vol 106 ◽  
pp. 9-16 ◽  
Author(s):  
Athena K. Petrides ◽  
Milenko J. Tanasijevic ◽  
Ellen M. Goonan ◽  
Adam B. Landman ◽  
Michalis Kantartjis ◽  
...  
Keyword(s):  
Information System ◽  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Record ◽  
Laboratory Information System ◽  
Academic Medical ◽  
Electronic Health

Moving Radiology Workflow to the Electronic Health Record: Quantitative and Qualitative Experience From a Large Academic Medical Center

2020 ◽  
Vol 27 (2) ◽  
pp. 253-259 ◽  
Author(s):  
Benjamin Wildman-Tobriner ◽  
Matthew P. Thorpe ◽  
Nicholas Said ◽  
Wendy L. Ehieli ◽  
Christopher J. Roth ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Radiology Workflow ◽  
Health Record ◽  
Academic Medical ◽  
Electronic Health

Abstract 15537: An Electronic Health Record Intervention to Optimize Utilization of Transthoracic Echocardiography: Opportunity for Cost Savings in the Era of Value Based-care

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jason Castaneda ◽  
corey rearick ◽  
Joseph Weber ◽  
Eve Edstrom ◽  
Kimisha Cassidy ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Transthoracic Echocardiography ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
Health Record ◽  
Post Intervention ◽  
Academic Medical ◽  
Electronic Health ◽  
Value Based Care

Introduction: In the current value-based era, targeting diagnostic resources and minimizing unnecessary testing is of paramount importance. Transthoracic echocardiography (TTE) is a common and costly test, and available Appropriate Use Criteria (AUC) guide optimal utilization. Limited TTE (L-TTE) shortens sonographer time, lowers cost and may be ideal for repeat TTEs (R-TTE) with a focused indication. However, many clinicians are unfamiliar with the AUC and opportunities for L-TTE. We prospectively tested an Electronic Health Record (EHR)-based intervention aimed at optimizing TTE utilization in a large academic medical center. Methods: TTE utilization at the University of Chicago Medicine was assessed over a 6-month period and complete TTE (C-TTE), L-TTE and R-TTE (TTE repeated within 6 months) were recorded. An EHR-based intervention was then implemented and TTE utilization was assessed over the ensuing 8 weeks. The intervention included presenting new descriptive L-TTE options (i.e. “Limited TTE: EF or Effusion Only”) when any “echo” was searched in the EHR order panel, an alert to prior TTEs (i.e. date & LVEF) and a link to AUC-based guidance for TTE ordering. Educational materials were also distributed to frequent TTE ordering providers. Results: Among 9121 TTEs (53% inpatient) pre-intervention , 11% (n=1002) were L-TTEs and 25% (n=2320) were R-TTEs. There were more L-TTEs and R-TTEs in pre-intervention inpatients compared to outpatients (L-TTE 14% vs 7%, p<0.0001, R-TTE 33% vs 17%, p<0.0001). Post-intervention (2879 TTEs, 53% inpatient), R-TTEs significantly decreased (22.6% vs 25.4%, p=0.0019) and L-TTEs significantly increased (14% vs 11%, p<0.0001) compared to pre-intervention, with inpatient TTEs most impacted (R-TTE 28% vs 33%, p=0.0016, L-TTE 19% vs 14%, p<0.001). The intervention’s greatest impact was to markedly increase L-TTEs among inpatient R-TTEs (44% vs 35%, p=0.0002). Conclusions: Despite AUC discouraging frequent repeat TTEs, R-TTEs are common in an academic medical center and utilization of L-TTE is rare. An EHR-based intervention with prior TTE alerts and descriptive L-TTE options increases L-TTEs and reduces R-TTEs. Further study is warranted to describe the full clinical and financial impact of this intervention.

Leveraging Structural Changes in an Electronic Health Record Tool to Standardize Written Handoff

2018 ◽  
Vol 34 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Jillian Zavodnick ◽  
Rebecca Jaffe ◽  
Marc Altshuler ◽  
Scott Cowan ◽  
Alexis Wickersham ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Structural Changes ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Record ◽  
Patient Handoff ◽  
Academic Medical ◽  
Effective Training ◽  
Before And After ◽  
Electronic Health

Miscommunications during patient handoff can lead to harm. The I-PASS bundle has been shown to improve safety outcomes. Although effective training reliably improves verbal handoffs, research has demonstrated a lack of effect on written handoffs. The objective was to compare written handoff before and after integration of a standardized electronic health record (EHR) tool. Interns at a large urban academic medical center underwent I-PASS handoff training. The EHR handoff tool was then revised to prompt the I-PASS components. Handoff documents were obtained before and after the intervention. More handoffs included Illness Severity (33% to 59%, P < .001) and Action List (65% to 83%, P = .005) after the intervention. There was no change in handoffs with miscommunications (12.5% to 10%, P = .566) or omissions (8% to 11%, P = .447). Handoffs including tangential or unrelated information decreased (20% to 4%, P = .001). A written handoff tool can reinforce the effect of training and increase adherence to I-PASS.

scholarly journals Impact of Laboratory Charge Display Within the Electronic Health Record Across an Entire Academic Medical Center

2017 ◽  
Vol 148 (6) ◽  
pp. 513-522 ◽  
Author(s):  
Robert L Schmidt ◽  
Jorie M Colbert-Getz ◽  
Caroline K Milne ◽  
Daniel J Vargo ◽  
Jerry W Hussong ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Record ◽  
Academic Medical ◽  
Electronic Health

scholarly journals Electronic Health Record Adoption – Maybe It’s not about the Money

2011 ◽  
Vol 02 (04) ◽  
pp. 460-471 ◽  
Author(s):  
A. Skinner ◽  
J. Windle ◽  
L. Grabenbauer
Keyword(s):  
Electronic Health Record ◽  
Patient Care ◽  
Resistance To Change ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Physician ◽  
Health Record ◽  
Record System ◽  
Intuitive Interfaces ◽  
Electronic Health

SummaryObjective: The slow adoption of electronic health record (EHR) systems has been linked to physician resistance to change and the expense of EHR adoption. This qualitative study was conducted to evaluate benefits, and clarify limitations of two mature, robust, comprehensive EHR Systems by tech-savvy physicians where resistance and expense are not at issue.Methods: Two EHR systems were examined – the paperless VistA / Computerized Patient Record System used at the Veterans‘ Administration, and the General Electric Centricity Enterprise system used at an academic medical center. A series of interviews was conducted with 20 EHR-savvy multi-institutional internal medicine (IM) faculty and house staff. Grounded theory was used to analyze the transcribed data and build themes. The relevance and importance of themes were constructed by examining their frequency, convergence, and intensity.Results: Despite eliminating resistance to both adoption and technology as drivers of acceptance, these two robust EHR’s are still viewed as having an adverse impact on two aspects of patient care, physician workflow and team communication. Both EHR’s had perceived strengths but also significant limitations and neither were able to satisfactorily address all of the physicians’ needs.Conclusion: Difficulties related to physician acceptance reflect real concerns about EHR impact on patient care. Physicians are optimistic about the future benefits of EHR systems, but are frustrated with the non-intuitive interfaces and cumbersome data searches of existing EHRs.

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