Comparing Patient-Reported Medical Problems with the Electronic Health Record Problem List

2016 ◽  
Vol 04 (03) ◽  
Author(s):  
Fernanda Polubriaginof CG ◽  
Paulo Pastore G
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Problem List ◽  
Medical Problems ◽  
Patient Reported ◽  
Electronic Health

What does social isolation have to do with my arthritis? Patient and provider views of the implementation of an electronic Social Determinants of Health risk assessment tool

2020 ◽  
Vol 64 (1) ◽  
pp. 707-710
Keyword(s):  
Electronic Health Record ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Assessment Tool ◽  
Determinants Of Health ◽  
Health Record ◽  
Institute Of Medicine ◽  
Patient Reported ◽  
Item Responses ◽  
Electronic Health

Social Determinants of Health (SDoH) are the conditions in which people are born, live, learn, work, and play that can affect health, functioning, and quality-of-life outcomes. The Institute of Medicine charged healthcare institutions with capturing and measuring patient SDoH risk factors through the electronic health record. Following the implementation of a social determinants of health electronic module across a major health institution, the response to institutional implementation was evaluated. To assess the response, a multidisciplinary team interviewed patients and providers, mapped the workflow, and performed simulated tests to trace the flow of SDoH data from survey item responses to visualization in EHR output for clinicians. Major results of this investigation were: 1) the lack of patient consensus about value of collecting SDOH data, and 2) the disjointed view of patient reported SDoH risks across patients, providers, and the electronic health record due to the way data was collected and visualized.

scholarly journals Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods

2019 ◽  
Vol 27 (3) ◽  
pp. 480-490 ◽  
Author(s):  
Adam Rule ◽  
Michael F Chiang ◽  
Michelle R Hribar
Keyword(s):  
Systematic Review ◽  
Access Control ◽  
Electronic Health Record ◽  
Chart Review ◽  
Observational Research ◽  
Clinical Activity ◽  
Health Record ◽  
Problem List ◽  
Inclusion Criteria ◽  
Electronic Health

Abstract Objective To systematically review published literature and identify consistency and variation in the aims, measures, and methods of studies using electronic health record (EHR) audit logs to observe clinical activities. Materials and Methods In July 2019, we searched PubMed for articles using EHR audit logs to study clinical activities. We coded and clustered the aims, measures, and methods of each article into recurring categories. We likewise extracted and summarized the methods used to validate measures derived from audit logs and limitations discussed of using audit logs for research. Results Eighty-five articles met inclusion criteria. Study aims included examining EHR use, care team dynamics, and clinical workflows. Studies employed 6 key audit log measures: counts of actions captured by audit logs (eg, problem list viewed), counts of higher-level activities imputed by researchers (eg, chart review), activity durations, activity sequences, activity clusters, and EHR user networks. Methods used to preprocess audit logs varied, including how authors filtered extraneous actions, mapped actions to higher-level activities, and interpreted repeated actions or gaps in activity. Nineteen studies validated results (22%), but only 9 (11%) through direct observation, demonstrating varying levels of measure accuracy. Discussion While originally designed to aid access control, EHR audit logs have been used to observe diverse clinical activities. However, most studies lack sufficient discussion of measure definition, calculation, and validation to support replication, comparison, and cross-study synthesis. Conclusion EHR audit logs have potential to scale observational research but the complexity of audit log measures necessitates greater methodological transparency and validated standards.

scholarly journals Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes

2020 ◽  
Vol 3 (6) ◽  
pp. e205867 ◽  
Author(s):  
Sigall K. Bell ◽  
Tom Delbanco ◽  
Joann G. Elmore ◽  
Patricia S. Fitzgerald ◽  
Alan Fossa ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Ambulatory Care ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health

Integrating patient-reported outcomes data into the electronic health record.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 186-186
Author(s):  
Brandon Bosch ◽  
Scott Hartman ◽  
Lauren Caldarello ◽  
Diane Denny, DBA
Keyword(s):  
Electronic Health Record ◽  
Population Analysis ◽  
Treatment Plan ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Patient Reported Outcome ◽  
Health Record ◽  
National Network ◽  
Patient Reported ◽  
Electronic Health

186 Background: As a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer, the network was an early adopter of using patient reported outcome (PRO) data as part of its routine patient assessment and treatment. Since 2012 an externally validated tool has been used to capture patients’ perceived symptom burden for real-time clinical intervention, from the point of first visit throughout the course of treatment, at intervals of 21 days or greater. Research has demonstrated the use of PRO data as a valuable component of a patient’s treatment plan, promoting improved quality and length of life. Methods: The use of this data across the network was expanded such that results once only accessible on paper and via electronically stored images, has now been fully integrated into the electronic health record (EHR). A multidisciplinary project team formulated the specifications for a successful integration of PRO data into the EHR. Results: The project achieved its goal and went beyond data integration to include implementation of a solution to facilitate documentation of intervention against patients’ symptoms. Provider workflow efficiency is greatly enhanced via single system access and visual notification, with critical values flagged, to focus providers’ attention on severe symptoms. Incorporation of a unified EHR flowsheet provides a paperless, one-stop symptom assessment approach and streamlined mechanism for intervention documentation. The documentation module leverages structured data fields and linkage of PRO data with interventions, such as specialist referrals or medication orders, to support enhanced patient care and quality improvement. Conclusions: The ability to easily view an array of patient reported concerns and document interventions against severe or significantly worsening symptoms provides clinicians an enhanced ability to address quality of life related needs. PRO data is now stored electronically in the enterprise warehouse, thus enabling aggregation with data from which to perform population analysis and eventually, pursue opportunities for predictive modeling.

scholarly journals Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report

2015 ◽  
Vol 23 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Christopher A Harle ◽  
Alyson Listhaus ◽  
Constanza M Covarrubias ◽  
Siegfried OF Schmidt ◽  
Sean Mackey ◽  
...  
Keyword(s):  
Case Report ◽  
Electronic Health Record ◽  
Patient Reported Outcomes ◽  
System Development ◽  
Lessons Learned ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health ◽  
Clinical Tools ◽  
The Right

Abstract In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden.

scholarly journals Capturing a Patient-Reported Measure of Physical Function Through an Online Electronic Health Record Patient Portal in an Ambulatory Clinic: Implementation Study (Preprint)

2017 ◽  
Author(s):  
Jing Li ◽  
Jinoos Yazdany ◽  
Laura Trupin ◽  
Zara Izadi ◽  
Milena Gianfrancesco ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Physical Function ◽  
Patient Reported Outcomes ◽  
Health Record ◽  
Patient Portal ◽  
Rheumatology Clinic ◽  
Patient Reported ◽  
Physical Function Score ◽  
Electronic Health ◽  
White Patients

BACKGROUND Despite significant interest in the collection of patient-reported outcomes to make care more patient-centered, few studies have evaluated implementation efforts to collect patient-reported outcomes from diverse patient populations OBJECTIVE We assessed the collection of patient-reported outcomes from rheumatoid arthritis patients in an academic rheumatology clinic, using a paper and an online form through the electronic health record patient portal. METHODS We identified patients seen between 2012-2016 with ≥2 face-to-face encounters with a rheumatology provider and International Classification of Diseases codes for RA, ≥30 days apart. In 2013, our clinic implemented a paper version of the Patient Reported Outcome Measurement Information System (PROMIS) physical function form that was administered to patients upon their check-in at the clinic. In 2015, an online version of the form became available by way of the electronic health record patient portal to patients with active portal accounts. We compared the proportion of visits with documented PROMIS scores across age, race and ethnicity, and language and examined trends over time using a control chart. RESULTS We included 1078 patients with rheumatoid arthritis with 7049 in-person encounters at the rheumatology clinic over 4 years, with an average of 168 visits per month. Of the included patients, 80.4% of patients (867/1078) were female and the mean age was 58 (SD 16) years. The overall PROMIS physical function score documentation increased from 60.4% (1081/1791) of visits in 2013 to 74.4% (905/1217) of visits in 2016. Online score documentation increased from 10.0% (148/1473) in 2015 to 19.3% (235/1217) in 2016. African American patients were least likely to have a PROMIS physical function score recorded (55/88, 62.5% compared to 792/990, 80.0% for other racial or ethnic groups; P<.001). Compared with white patients, both African American and Hispanic patients were less likely to have active online electronic health record portal accounts (44/88, 50% and 90/157, 57.3% respectively, compared to 437/521, 83.9% of white patients; P<.001) and, once activated, less likely to use the online survey (6/44, 13.6% and 16/90, 17.8% respectively, compared to 135/437, 30.9% of white patients; P=.02). There was no significant difference in the proportion of any PROMIS physical function forms recorded between non-English vs English preferred patients. No significant differences were found across age or gender. CONCLUSIONS PROMIS physical function form completion improved overall from 2012-2016 but lagged among racial and ethnic minorities and non-English preferred patients. Future studies should address issues of portal access, enrollment, satisfaction, and persistence and focus on developing PRO implementation strategies that accommodate the needs and preferences of diverse populations.

Implementation and early adaptation of patient-reported outcome measures into an electronic health record: A technical report

2018 ◽  
Vol 26 (1) ◽  
pp. 129-140 ◽  
Author(s):  
Heather Taffet Gold ◽  
Raj J Karia ◽  
Alissa Link ◽  
Rachel Lebwohl ◽  
Joseph D Zuckerman ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Outcome Measures ◽  
Computerized Adaptive Testing ◽  
Clinical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Information ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health

We integrated and optimized patient-reported outcome measures into the electronic health record to provide quantitative, objective data regarding patients’ health status, which is important for patient care, payer contracts, and research. With a multidisciplinary team from information technology, clinical informatics, population health, and physician champions, we used formal human–computer interaction techniques and user-centered design to integrate several technology platforms and computerized adaptive testing for the National Institutes of Health Patient-Reported Outcomes Measurement Information System. The patient-reported outcome measure system leverages software frequently used by health systems and provides data for research and clinical care via a mobile-responsive web application using Symfony, with REDCap for configuring assessments and de-identified data storage. The system incorporates Oracle databases and Epic flowsheets. Patients complete patient-reported outcome measures, with data viewable in MyChart and Epic Synopsis Reports. Researchers can access data portals. The highly usable, successful patient-reported outcome measures platform is acceptable to patients and clinicians and achieved 73 percent overall completion rates.

Sign in / Sign up

Export Citation Format

Share Document