Engaging End-Users in Electronic Health Record (EHR) Updates: Social Workers’ Opinions on Integrating a Psychosocial Acuity Scale at a Large Urban Pediatric Hospital

2021 ◽  
pp. 1-21
Author(s):  
Abigail M. Ross ◽  
Matthew Tvedte ◽  
Susan Shanske ◽  
Nicole Lamontagne ◽  
Paige Sable ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Social Workers ◽  
End Users ◽  
Health Record ◽  
Pediatric Hospital ◽  
Electronic Health

scholarly journals The complex case of EHRs: examining the factors impacting the EHR user experience

2019 ◽  
Vol 26 (7) ◽  
pp. 673-677 ◽  
Author(s):  
Michael A Tutty ◽  
Lindsey E Carlasare ◽  
Stacy Lloyd ◽  
Christine A Sinsky
Keyword(s):  
Electronic Health Record ◽  
Health System ◽  
User Experience ◽  
End Users ◽  
Complex Case ◽  
Health Record ◽  
System Leadership ◽  
Electronic Health ◽  
Face Time ◽  
Administrative Tasks

Abstract Physicians can spend more time completing administrative tasks in their electronic health record (EHR) than engaging in direct face time with patients. Increasing rates of burnout associated with EHR use necessitate improvements in how EHRs are developed and used. Although EHR design often bears the brunt of the blame for frustrations expressed by physicians, the EHR user experience is influenced by a variety of factors, including decisions made by entities other than the developers and end users, such as regulators, policymakers, and administrators. Identifying these key influences can help create a deeper understanding of the challenges in developing a better EHR user experience. There are multiple opportunities for regulators, policymakers, EHR developers, payers, health system leadership, and users each to make changes to collectively improve the use and efficacy of EHRs.

The Electronic Health Record: Documenting the Unique Contributions of Social Workers

2019 ◽  
Vol 44 (2) ◽  
pp. 123-128
Author(s):  
Jeannine Rowe ◽  
Victoria M Rizzo ◽  
Deanna Guthrie ◽  
Matthew R Vail ◽  
Suk-Young Kang ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Social Workers ◽  
Health Record ◽  
Electronic Health

Who, what, where, when, and how? Advance care planning documentation practices and accessibility in the electronic health record.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 2-2
Author(s):  
Evan Justin Walker ◽  
Ryan Mcmahan ◽  
Deborah Barnes ◽  
Mary Katen ◽  
Daniela Lamas ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Social Workers ◽  
Advance Directives ◽  
Advance Care Planning ◽  
Primary Care Providers ◽  
Health Record ◽  
Care Planning ◽  
Advance Care ◽  
Electronic Health

2 Background: Documenting patients’ advance care planning (ACP) wishes is essential to providing value aligned care, as is having this documentation readily accessible. Early ACP is increasingly being recognized as integral to oncologic care, however, little is known about current documentation practices. In this cross-sectional study, we describe ACP documentation practices and accessibility of documented ACP discussions in the electronic health record (EHR). Methods: Participants were recruited from outpatient clinics at the San Francisco VA, were ≥60 years old, with ≥2 chronic/serious conditions and ≥2 primary care visits in the past year. ACP documentation was abstracted from the EHR in 2013-2015 and included any prior legal forms/orders and ACP discussions documented within the prior five years. Frequency and type of ACP documentation was calculated using percentages and means. For discussions, author discipline and location of documentation was determined. Discussions were deemed “accessible” if documented in a designated ACP posting location or “not easily accessible” if recorded as free text in progress notes. Results: The mean age of 414 participants was 71 years (SD ± 8), 9% were women, 43% were non-white, and 51% had documented ACP including 149 (36%) with ACP forms and 138 (33%) with ACP discussions. Seventy-five (54%) discussions were documented by social workers and 49 (36%) by primary care providers. However, 76 (55%) discussions were not easily accessible. For 27 (18%) participants with advance directives, subsequent discussions documented a change in treatment preferences. Nineteen (70%) discussions reporting a change in wishes were not easily accessible. Conclusions: Half of chronically ill, older patients had documented ACP wishes, including a third with documented ACP discussions. Most discussions were documented by social workers and were not easily accessible, although discussions often represented changes from prior advance directives. Clinician education and EHR changes to ensure documented discussions are accessible are important patient-safety and quality improvement targets to ensure patients’ wishes are honored.

scholarly journals A framework for evaluating electronic health record vendor user-centered design and usability testing processes

2016 ◽  
Vol 24 (e1) ◽  
pp. e35-e39 ◽  
Author(s):  
Raj M Ratwani ◽  
A Zachary Hettinger ◽  
Allison Kosydar ◽  
Rollin J Fairbanks ◽  
Michael L Hodgkins
Keyword(s):  
Best Practices ◽  
Human Factors ◽  
Electronic Health Record ◽  
Usability Testing ◽  
End Users ◽  
Health Record ◽  
User Centered Design ◽  
Electronic Health ◽  
Certification Requirements ◽  
User Centered

Objective: Currently, there are few resources for electronic health record (EHR) purchasers and end users to understand the usability processes employed by EHR vendors during product design and development. We developed a framework, based on human factors literature and industry standards, to systematically evaluate the user-centered design processes and usability testing methods used by EHR vendors. Materials and Methods: We reviewed current usability certification requirements and the human factors literature to develop a 15-point framework for evaluating EHR products. The framework is based on 3 dimensions: user-centered design process, summative testing methodology, and summative testing results. Two vendor usability reports were retrieved from the Office of the National Coordinator’s Certified Health IT Product List and were evaluated using the framework. Results: One vendor scored low on the framework (5 pts) while the other vendor scored high on the framework (15 pts). The 2 scored vendor reports demonstrate the framework’s ability to discriminate between the variabilities in vendor processes and to determine which vendors are meeting best practices. Discussion: The framework provides a method to more easily comprehend EHR vendors’ usability processes and serves to highlight where EHR vendors may be falling short in terms of best practices. The framework provides a greater level of transparency for both purchasers and end users of EHRs. Conclusion: The framework highlights the need for clearer certification requirements and suggests that the authorized certification bodies that examine vendor usability reports may need to be provided with clearer guidance.

scholarly journals Identifying End Users' Preferences about Structuring Pharmacogenetic Test Orders in an Electronic Health Record System

2020 ◽  
Vol 22 (10) ◽  
pp. 1264-1271
Author(s):  
Leland E. Hull ◽  
Jason L. Vassy ◽  
Annjanette Stone ◽  
Catherine C. Chanfreau-Coffinier ◽  
Craig W. Heise ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
End Users ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Pharmacogenetic Test ◽  
Electronic Health

scholarly journals An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework

2019 ◽  
Vol 10 (05) ◽  
pp. 964-971 ◽  
Author(s):  
Wendy Kiepek ◽  
Patricia P. Sengstack
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Initial Phase ◽  
End Users ◽  
Lessons Learned ◽  
Health Record ◽  
End User ◽  
Support Personnel ◽  
User Support ◽  
Electronic Health

Abstract Background Electronic health record (EHR) system implementation is complex. Strong support for clinicians and other end-users during the initial phase of implementation requires dedicated resources and commitment to ensure a smooth transition, reduce frustration, and assist in adoption. Objectives Evaluate end-user support processes and personnel employed during the initial phase of EHR implementation at an academic medical center and identify facilitators of success, challenges, and lessons learned. Methods Using the model for improvement framework, this case report describes the activities that follow the concepts of planning, doing, studying, and acting (PDSA) when providing on-site support to system end users during an EHR implementation in a complex health care system. Results Strengths included engaged and supportive leadership, use of internal support personnel, use of zone leaders, daily huddles for effective dissemination of information, and an evaluation survey tool to provide data supporting rapid changes in support personnel allocation. Challenges primarily surrounded the management of over 1,000 external support personnel which included limited EHR system knowledge, scheduling, and transportation logistics. Conclusion Implementation of EHR systems continues. Supporting end users is one aspect of these complex projects that require dedicated resources to manage effectively. Organizations taking a more proactive approach, based on learning from experiences, as well as from other health care organizations, can improve their ability to take on this challenge armed with best practices and lessons learned.

scholarly journals Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital

2018 ◽  
Vol 09 (01) ◽  
pp. 037-045 ◽  
Author(s):  
Allan Simpao ◽  
Luis Ahumada ◽  
Beatriz Larru Martinez ◽  
Ana Cardenas ◽  
Talene Metjian ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Visual Analytics ◽  
Prescribing Patterns ◽  
Empiric Antibiotic Therapy ◽  
Health Record ◽  
Pediatric Hospital ◽  
National Guidelines ◽  
Monthly Basis ◽  
Susceptibility Data ◽  
Electronic Health

Background Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. Objective We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram (“e-antibiogram”) that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data. Methods We used visual analytics software to develop a secure, EHR-linked, condition- and patient-specific e-antibiogram that supplies susceptibility maps for organisms and antibiotics in a comprehensive report that is updated on a monthly basis. Antimicrobial susceptibility data were grouped into nine clinical scenarios according to the specimen source, hospital unit, and infection type. We implemented the e-antibiogram within the EHR system at Children's Hospital of Philadelphia, a tertiary pediatric hospital and analyzed e-antibiogram access sessions from March 2016 to March 2017. Results The e-antibiogram was implemented in the EHR with over 6,000 inpatient, 4,500 outpatient, and 3,900 emergency department isolates. The e-antibiogram provides access to rolling 12-month pathogen and susceptibility data that is updated on a monthly basis. E-antibiogram access sessions increased from an average of 261 sessions per month during the first 3 months of the study to 345 sessions per month during the final 3 months. Conclusion An e-antibiogram that was built and is updated using EHR data and adheres to national guidelines is a feasible replacement for an annual, static, manually compiled antibiogram. Future research will examine the impact of the e-antibiogram on antibiotic prescribing patterns.

Business: The Electronic Health Record: Front Line Experience

2011 ◽  
Vol 21 (1) ◽  
pp. 18-22
Author(s):  
Rosemary Griffin
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Electronic Health Record ◽  
Financial Incentives ◽  
Best Practice ◽  
Health Care Systems ◽  
The United States ◽  
Health Record ◽  
Health Trends ◽  
Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

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