EHR-based Visualization Tool: Adoption Rates, Satisfaction, and Patient Outcomes

Abstract

Background:Electronic health records (EHRs) have the potential to enhance patient-provider communication and improve patient outcomes. However, in order to impact patient care, clinical decision support (CDS) and communication tools targeting such needs must be integrated into clinical workflow and be flexible with regard to the changing health care landscape.Design:The Stroke Prevention in Healthcare Delivery Environments (SPHERE) team developed and implemented the SPHERE tool, an EHR-based CDS visualization, to enhance patient-provider communication around cardiovascular health (CVH) within an outpatient primary care setting of a large academic medical center.Implementation:We describe our successful CDS alert implementation strategy and report adoption rates. We also present results of a provider satisfaction survey showing that the SPHERE tool delivers appropriate content in a timely manner. Patient outcomes following implementation of the tool indicate one-year improvements in some CVH metrics, such as body mass index and diabetes.Discussion:Clinical decision-making and practices change rapidly and in parallel to simultaneous changes in the health care landscape and EHR usage. Based on these observations and our preliminary results, we have found that an integrated, extensible, and workflow-aware CDS tool is critical to enhancing patient-provider communications and influencing patient outcomes.

Active Use of Electronic Health Records (EHRs) and Personal Health Records (PHRs) for Epidemiologic Research: Sample Representativeness and Nonresponse Bias in a Study of Women During Pregnancy

“…Passive use includes activities such as secondary data analysis or identification of patients that meet specific phenotypic requirements. Active use includes engaging patients via the use of platforms such as the EHR and PHR for recruitment and outcomes data collection 1,9,10. The overall goal of this study is to describe the use, strengths, and limitations of the EHR for identifying potential study participants and the PHR for recruiting and collecting contextual data for an observational research study.…”

The geographic distribution of cardiovascular health in the stroke prevention in healthcare delivery environments (SPHERE) study

“…Designing best practice alerts that then utilize these visualizations may be helpful in the time-limited clinical environment and warrants further study. While we have found provider satisfaction to be high with regard to the SPHERE application, 59 patient and provider acceptability of delivering these current data to the EHR during the clinical encounter would need to be reassessed.…”

“…Specifically, we developed a novel methodology for integrating cancer registry data, spatial cluster analysis, and map creation using SAS statistical software. This same automated technique 58 could be applied to the data explored here and combined with our SPHERE visualization platform 59,60 to present these data – embedded in the EHR – at the point of care. While the data described in this paper represents an exploratory analysis, the information architecture and automation we developed would enable us to scale it and continue to explore these integrated data sets to find meaningful trends.…”

Oncologists' Perceptions of a Digital Tool to Improve Cancer Survivors' Cardiovascular Health

“…24 Digital health technologies have the potential to improve cancer survivorship care 25 and have demonstrated effectiveness in other settings and populations. 26,27 The broad category of digital health technology includes such things as mHealth applications designed for smartphones or tablets, electronic health records and patient portals, e-prescribing, wearable devices, telehealth, and telemedicine. 28 In 2018, the World Health Organization published a taxonomy of digital health interventions under the following four broad categories: (1) clients, (2) health care providers, (3) health system managers, and (4) data services.…”