Electronic Medical Record System Use in Canada: Integrating Physiology Flowsheets

Abstract

Background: Longitudinal data of pulmonary physiology (pulmonary function tests, PFTs) is important in diagnosis and management of both respiratory and non-respiratory diseases that have secondary effects on lungs. Large amounts of data need to be amalgamated in physiology flowsheets within electronic medical records (EMR), which summarize trends of multiple PFT reports in one document. We present the process around evaluation and implementation of a physiology flowsheet with discreet data elements. Methods: Alberta Health Services (AHS) has chosen a single vendor for its EMR, an Epic-based system (Epic Systems Corporation). A new clinical tool was written and implemented/piloted within the pulmonary department of the EMR. The physiology flowsheet was tested, modified, and real patient data was entered for those followed longitudinally within AHS Pulmonary Function Laboratories. A pre- and post-implementation survey was carried out with different front-line users to evaluate their experiences. Results: From this pilot implementation, we found that majority of EMR users reported variable ease and satisfaction with the current access to PFT’s. Flowsheets were deemed helpful, once longitudinal data was available. Consistently respondents reported that the EMR slows patient encounters. Healthcare providers also reported flowsheets to be useful for patient education and their self-reflection related to disease processes. Patient surveys were not conducted. Conclusions: Current data transfer of PFT results to EMR requires manual entry, which is time-consuming, though clinically useful. The incorporation of raw data from PFT software to EMR is of great importance in both clinical assessments and patient education; however, a systems-based approach is needed.