MyPOD: an EMR-Based Tool that Facilitates Quality Improvement and Maintenance of Certification

Abstract

Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period. During the first 18 months of using MyPOD, 691 cases were captured in both MyPOD and NSQIP-P. There were 48 cases with occurrences in NSQIP-P (6.9% occurrence rate). MyPOD captured 33% of the occurrences and 83% of the deaths reported in NSQIP-P. Use of the MyPOD program helped to identify series of complications and facilitated systematic change to improve outcomes. MyPOD provides comparative data that is essential in performance evaluation and facilitates quality improvement in surgery. This program and similar EMR-driven tools are becoming essential components of the MOC process. Our initial review has revealed opportunities for improvement in self-reporting which we can continue to measure by comparison to NSQIP-P. In addition, it has identified systems issues that have led to hospital-wide improvements.

Pediatric Surgeon Perceptions of Participation in External Patient Safety Programs: impact on Patient Safety

“…10 In a single institution retrospective comparison of NSQIP with traditional M&M conference over a 1-year period, NSQIP identified 143 patients with complications as opposed to 58 in M&M. The NSQIP also identified more postoperative deaths and a higher proportion of surgical-site infections and readmissions. Another study that compared NSQIP-Pediatric (NSQIP-P) with surgeon-reported complications at M&M found that M&M captured only 33% of the complications and 83% of the deaths reported in NSQIP-P. 11 Surgical resident reporting also appears to capture pediatric perioperative complications inadequately when compared with the NSQIP-P database. In a 1-year study in a single institution, residents reported 27 complications, as compared to 68 by NSQIP-P.…”

Electronic Health Records That Support Health Professional Reflective Practice: a Missed Opportunity in Digital Health

“…EHRs are information systems used by healthcare organisations around the world to capture data on patient care. In the context of digital health, the literature has explored EHR technology from many perspectives such as: Investigating the knowledge and skills the health workforce require to utilise EHRs and the data within them [ 16 , 22 ]; Understanding how organisations can efficiently implement EHRs [ 23 ] and their use as signifiers of digital maturity [ 24 ]; Evaluating the use of EHRs to undertake research that is integrated with routine clinical care [ 25 ]; Investigating the effectiveness of the use of EHRs as tools for improving quality of care [ 26 , 27 ] and predicting health trajectories [ 28 ]; Exploring the potential of EHRs to support virtual care and other new healthcare models [ 29 ] and many applications beyond these. …”

“…Investigating the effectiveness of the use of EHRs as tools for improving quality of care [ 26 , 27 ] and predicting health trajectories [ 28 ];…”

Providers preferences towards greater patient health benefit is associated with higher quality of care

“…program launched by the Robert Wood Johnson Foundation, for example, focused on providing transparent and public reporting of provider performance (Christianson, 2016). Similarly, the "MyPOD" program instituted at a children's hospital in Wilmington, DE, relied on electronic medical record data as well as self-reporting by surgeons, to track and target surgeon-specific outcomes (Berman, 2017). Additional programs have focused on assessing patient satisfaction to improve quality of care (Barr, 2006;Harris, 1999;Arnetz, 1996).…”