scholarly journals Electronic Health Records in Specialized Pediatric Palliative Care: A Qualitative Needs Assessment among Professionals Experienced and Inexperienced in Electronic Documentation

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 249
Author(s):  
Dorothee Meyer ◽  
Sven Kernebeck ◽  
Theresa Sophie Busse ◽  
Jan Ehlers ◽  
Julia Wager ◽  
...  
Keyword(s):  
Palliative Care ◽  
Electronic Health Records ◽  
Pediatric Palliative Care ◽  
Electronic Documentation ◽  
Health Records ◽  
Qualitative Research Design ◽  
Study Results ◽  
Electronic Health ◽  
Group Interviews ◽  
Outpatient Settings

Background: Currently, to the best of our knowledge, no findings exist concerning the needs of professionals in specialized pediatric palliative care (PPC) regarding electronic health records (EHRs). Several studies have highlighted benefits concerning the use of EHRs in pediatrics. However, usability is strongly affected by the degree of adaptivity to the context of application. The aim of this study is to examine the needs of professionals concerning an EHR in the specialized PPC inpatient and outpatient settings. Methods: A qualitative research design was chosen to address the complex aspects of user demands. Focus group interviews and semi-structured one-on-one interviews were conducted with PPC professionals. N = 23 participants from inpatient and N = 11 participants from outpatient settings of specialized PPC representing various professions took part in the study. Results: The findings could be grouped into four categories: (1) attitude towards the current methods of documentation, (2) attitude towards electronic documentation in general, (3) general requirements for an EHR, and (4) content requirements for an EHR. Conclusions: Professionals in specialized PPC expect and experience many benefits of using electronic documentation. Their requirements for an EHR for inpatient and outpatient settings of PPC are largely consistent with EHRs for pediatrics. However, individual specifications and adaptations are necessary for this particular setting.

Handoff Communication and Electronic Health Records

2014 ◽  
Vol 3 (1) ◽  
pp. 162-169 ◽  
Author(s):  
Julie Apker ◽  
Christopher Beach ◽  
Kevin O’Leary ◽  
Jennifer Ptacek ◽  
Dickson Cheung ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Patient Care ◽  
Healthcare Delivery ◽  
Communication Style ◽  
Health Records ◽  
Practical Applications ◽  
Sensemaking Theory ◽  
Making Sense ◽  
Study Results ◽  
Electronic Health

When transferring patient care responsibilities across the healthcare continuum, clinicians strive to communicate safely and effectively, but communication failures exist that threaten patient safety. Although researchers are making great strides in understanding and solving intraservice handoff problems, inter-service transition communication remains underexplored. Further, electronic health records (EHRs) figure prominently in healthcare delivery, but less is known about how EHRs contribute to inter-service handoffs. This descriptive, qualitative study uses Sensemaking Theory to explore EHR-facilitated, inter-service handoffs occurring between emergency medicine and internal/hospitalist medicine physicians. The researchers conducted six focus groups with 16 attending physicians and medical residents at a major Midwestern academic hospital. Findings suggest clinicians hold varied expectations for information content and relational communication/style. Their expectations contribute to making sense of uncertain handoff situations and communication best practices. Participants generally perceive EHRs as tools that, when used appropriately, can enhance handoffs and patient care continuity. Ideas for practical applications are offered based on study results.

scholarly journals Remote symptom monitoring integrated into electronic health records: A systematic review

2020 ◽  
Vol 27 (11) ◽  
pp. 1752-1763
Author(s):  
Julie Gandrup ◽  
Syed Mustafa Ali ◽  
John McBeth ◽  
Sabine N van der Veer ◽  
William G Dixon
Keyword(s):  
Systematic Review ◽  
Electronic Health Records ◽  
Clinical Care ◽  
Long Term Conditions ◽  
Health Records ◽  
Symptom Monitoring ◽  
Study Results ◽  
Patient Reported ◽  
Electronic Health

Abstract Objective People with long-term conditions require serial clinical assessments. Digital patient-reported symptoms collected between visits can inform these, especially if integrated into electronic health records (EHRs) and clinical workflows. This systematic review identified and summarized EHR-integrated systems to remotely collect patient-reported symptoms and examined their anticipated and realized benefits in long-term conditions. Materials and Methods We searched Medline, Web of Science, and Embase. Inclusion criteria were symptom reporting systems in adults with long-term conditions; data integrated into the EHR; data collection outside of clinic; data used in clinical care. We synthesized data thematically. Benefits were assessed against a list of outcome indicators. We critically appraised studies using the Mixed Methods Appraisal Tool. Results We included 12 studies representing 10 systems. Seven were in oncology. Systems were technically and functionally heterogeneous, with the majority being fully integrated (data viewable in the EHR). Half of the systems enabled regular symptom tracking between visits. We identified 3 symptom report-guided clinical workflows: Consultation-only (data used during consultation, n = 5), alert-based (real-time alerts for providers, n = 4) and patient-initiated visits (n = 1). Few author-described anticipated benefits, primarily to improve communication and resultant health outcomes, were realized based on the study results, and were only supported by evidence from early-stage qualitative studies. Studies were primarily feasibility and pilot studies of acceptable quality. Discussion and Conclusions EHR-integrated remote symptom monitoring is possible, but there are few published efforts to inform development of these systems. Currently there is limited evidence that this improves care and outcomes, warranting future robust, quantitative studies of efficacy and effectiveness.

scholarly journals Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores

2017 ◽  
Vol 08 (03) ◽  
pp. 880-892 ◽  
Author(s):  
Rong Chen ◽  
Hans Blomqvist ◽  
Sabine Koch ◽  
Niclas Skyttberg
Keyword(s):  
Decision Support ◽  
Electronic Health Records ◽  
Data Quality ◽  
Emergency Care ◽  
Vital Sign ◽  
Vital Signs ◽  
Clinical Decision ◽  
Electronic Documentation ◽  
Health Records ◽  
Electronic Health

Summary Background: Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. Objectives: This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. Methods: We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories –plausibility and concordance –were used. Results: The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Conclusion: Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely electronic. Citation: Skyttberg N, Chen R, Blomqvist H, Koch S. Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores. Appl Clin Inform 2017; 8: 880–892 https://doi.org/10.4338/ACI-2017-05-RA-0075

scholarly journals Interaction Time with Electronic Health Records: A Systematic Review

2021 ◽  
Vol 12 (04) ◽  
pp. 788-799
Author(s):  
Yuliya Pinevich ◽  
Kathryn J. Clark ◽  
Andrew M. Harrison ◽  
Brian W. Pickering ◽  
Vitaly Herasevich
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Interaction Time ◽  
Care Providers ◽  
Health Records ◽  
Inpatient Settings ◽  
Electronic Health ◽  
Outpatient Settings

Abstract Background The amount of time that health care clinicians (physicians and nurses) spend interacting with the electronic health record is not well understood. Objective This study aimed to evaluate the time that health care providers spend interacting with electronic health records (EHR). Methods Data are retrieved from Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations and Daily, (Ovid) Embase, CINAHL, and SCOPUS. Study Eligibility Criteria Peer-reviewed studies that describe the use of EHR and include measurement of time either in hours, minutes, or in the percentage of a clinician's workday. Papers were written in English and published between 1990 and 2021. Participants All physicians and nurses involved in inpatient and outpatient settings. Study Appraisal and Synthesis Methods A narrative synthesis of the results, providing summaries of interaction time with EHR. The studies were rated according to Quality Assessment Tool for Studies with Diverse Designs. Results Out of 5,133 de-duplicated references identified through database searching, 18 met inclusion criteria. Most were time-motion studies (50%) that followed by logged-based analysis (44%). Most were conducted in the United States (94%) and examined a clinician workflow in the inpatient settings (83%). The average time was nearly 37% of time of their workday by physicians in both inpatient and outpatient settings and 22% of the workday by nurses in inpatient settings. The studies showed methodological heterogeneity. Conclusion This systematic review evaluates the time that health care providers spend interacting with EHR. Interaction time with EHR varies depending on clinicians' roles and clinical settings, computer systems, and users' experience. The average time spent by physicians on EHR exceeded one-third of their workday. The finding is a possible indicator that the EHR has room for usability, functionality improvement, and workflow optimization.

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