Successful utilization of the EMR in a multiple sclerosis clinic to support quality improvement and research initiatives at the point of care

Abstract

BackgroundMany physicians enter data into the electronic medical record (EMR) as unstructured free text and not as discrete data, making it challenging to use for quality improvement or research initiatives.ObjectivesThe objective of this research paper was to develop and implement a structured clinical documentation support (SCDS) toolkit within the EMR to facilitate quality initiatives and practice-based research in a multiple sclerosis (MS) practice.MethodsWe built customized EMR toolkits to capture standardized data at office visits. Content was determined through physician consensus on necessary elements to support best practices in treating patients with demyelinating disorders. We also developed CDS tools and best practice advisories within the toolkits to alert physicians when a quality improvement opportunity exists, including enrollment into our DNA biobanking study at the point of care.ResultsWe have used the toolkit to evaluate 541 MS patients in our clinic and begun collecting longitudinal data on patients who return for annual visits. We provide a description and example screenshots of our toolkits, and a brief description of our cohort to date.ConclusionsThe EMR can be effectively structured to standardize MS clinic office visits, capture data, and support quality improvement and practice-based research initiatives at the point of care.

Can We Improve the Monitoring of People With Multiple Sclerosis Using Simple Tools, Data Sharing, and Patient Engagement?

“…Results from tests that (i) are relatively straightforward to implement in clinic and (ii) can be translated into selfmonitoring tools can be combined with PRO questionnaires and fed into the patient record, which, in health care settings covering large numbers of pwMS, is usually an electronic health record (EHR). EHRs facilitate the timely recording of patient data and the simultaneous navigation by multiple HCPs from different specialities (39). Coding terminology, such as Systematized Nomenclature for Medicine (SNOMED), provides a powerful resource to collate individual patient data as well as to identify, stratify, and audit patient cohorts and outcomes.…”

Electronic Health Interventions in the Case of Multiple Sclerosis: From Theory to Practice

“…Another intervention is the MS SCDS toolkit that facilitates quality initiatives and ensures that care conforms to best practices. This toolkit supports initial and follow-up visits [ 84 ].…”

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 ];…”