Electronic Health Records

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How EHRs can stop information overload, streamline workflow

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- In a sea full of patient information, quality statistics, and other data, hospitals are struggling to navigate their way to success. Data inflow has grown exponentially in the past decade or so as a result of an increasing emphasis on care value, evidence-based treatment and care collaboration.

Today’s referrals to multiple specialists mean a slew of specialist notes must be created and shared. The number of tests and therapies now available also contributes to the wash of clinical data.

As patients become more involved in their own healthcare decisions, requests for second and third opinions are becoming increasingly common. Add in family queries for records, the detailed data required by payers, and information mandated by meaningful use and other legislation, and it’s easy to see why hospitals are bending under the weight of information overload.

According to a rule of thumb used by IT storage experts, a typical physician generates a full gigabyte of data per year. That is why hospitals and other organizations with multiple IT systems and suboptimal interfaces are likely to find their digital workflows difficult to manage. Providers who find themselves generating orders in one system but following up in a completely different system, for instance, may end up manually tracking down results, leading to the potential for errors and inconsistencies that could affect patient outcomes and reimbursements.

Amidst all these changes, electronic health records (EHRs) can help hospitals keep up with data flow through a number of intuitive features, such as alerts and automated tracking tools. By engaging an enterprise EHR, hospitals can optimize their operations, resulting in less stress on staff and more time for patients.

READ MORE: Study Raises Doubts about Clinical Documentation Accuracy

Having the right EHR, however, is critical. Veterans Health Information Systems and Technology Architecture, known as VistA, is one such EHR that was engineered and adapted over time to support a high-quality medical care environment for the military veterans in clinical settings and medical care delivery systems. Numerous private and public care settings, including large medical centers and health systems, now use VistA for its flexibility to be customized and scalable due to its open source nature, allowing the system to adapt to numerous care settings and needs.

Tips to identify, share, and manage

Especially when resources are limited, successfully managing information to prevent overload requires first identifying exactly which information is most important. To do this, hospitals must:

• Evaluate the minimum data set necessary to meet regulatory and reimbursement criteria. The organizational workflow should then be built backward from that minimum information. For example, if specific readmission data are needed to ensure maximum reimbursement, look at who typically gathers, tracks and uses that information to ensure they have the appropriate means to do so.

• Determine what types of clinical information the hospital’s providers find helpful to their daily workflows.

READ MORE: How Health Orgs Realize EHR Benefits, Quality Improvements

• Assess which information is often missing for billing, operational or care quality purposes.

Once the information vital to a particular hospital has been identified, EHR functionalities can help capture and share it quickly and easily. For example, templates can be created to seize information as orders are being written or tests are performed. One key is to choose an EHR, like VistA, that can adapt to providers’ preferences and workflow. An application that can only be used the way it was designed (a “boxed” solution) is likely to increase information overload, not reduce it.

To further reduce data “noise,” also pay close attention to an EHR’s alert features and functionality. On average, a physician can expect to receive 63 clinical alerts per day, so using the default alert settings may lead to information overload at the very least — and alert fatigue at worst. Keep in mind that just because an alert is possible does not mean it is necessary.

Set interdisciplinary alerts strategically, notifying only those who need them about only the information identified as important. Often this will involve creating role-based alerts. For example, notification that lab tests must be ordered before a patient begins taking a certain medication could go to the nurse rather than the physician. Similarly, the compliance officer could request an alert any time specific physician documentation is missing from the record.

Customization plays a crucial role in minimizing data overload, as well. For instance, developing cover sheets with a summary of relevant patient information can help physicians who share patients or who cover for one another; these can also help smooth care transitions and patient handoffs. Furthermore, if a group of recipients is offered the same notification, make sure the EHR can be set so that a response from one provider deletes the alert from the rest of the recipients, in order to prevent confusion and duplication of effort.

READ MORE: EHR Clinical Decision Support Alerts Increase HPV Vaccination

Successful data navigation, better patient care

Controlling the often overwhelming flow of information has become progressively more important over the last few years, especially for hospitals. Facility clinical and IT personnel who feel they are swimming against the tide should consider how a properly configured EHR can help achieve effective data management.

By engaging an EHR, hospitals can become more efficient and will be equipped with the right tools and resources needed to help cope with the onslaught of patient data they are required to process and performance data they are obligated to provide for reimbursement.

By simply having all information readily available in one place, they are free to spend more time seeing patients, rather than hunting for data. Engaging technology to streamline workflow and prevent information overload allows hospitals to keep their focus on their top priority: the delivery of patient care.

Mark Byers is CEO, president and co-founder of DSS Inc. He is a Service Disabled Veteran (United States Air Force). His professional software development experience spans more than 33 years in the data processing industry, of which more than 20 years have involved the development of electronic document management software. He has also been actively involved in the development of electronic health record software for over 16 years.

 

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