Optimizing Usability of Electronic Medical Records to Meet and Measure Quality Initiatives

Abstract

<p><strong>Purpose:</strong></p> <p>The purpose of this evidence based practice project is to improve usability of the Electronic Medical Record (EMR) to demonstrate consistent compliance with venous thromboembolism (VTE) and heart failure (HF) Core Measures. Consistently meeting core measures is important for optimal patient care and reimbursement.. </p> <p><strong>Strength of Evidence: </strong>Systematic reviews, a multinational cross-sectional study, and a multicenter, randomized controlled trial all demonstrate a positive impact on suboptimal prophylaxis and treatment for VTE and HF quality measures, with improved EMR usability. </p> <p><strong> </strong></p> <p><strong>Proposed Practice Change:</strong></p> <p>The proposed change involves modifying the EMR program in order to improve usability in order entry, documentation, efficiency of review, and communication between reviewers and clinicians. This will require modifying the EMR program in order to improve usability, order entry, documentation, efficiency of review, and communication between reviewers and clinicians<strong></strong></p> <p><strong>Implementation Strategies:</strong> EMR program changes aimed at promoting appropriate orders include building specific orders into all admission order sets. The changes aimed at promoting appropriate documentation include building in reminders for nursing staff. Those intended to promote efficient review include creating views for quality nurses to review orders and documentation for these quality measures which pull pertinent information from the EMR, negating the need for individual, manual chart review. The changes to the EMR aimed at improving communication include developing instant messaging within EMR to facilitate communication between quality nurses and staff nurses and physicians.</p> <p><strong>Stakeholders/Evaluation: </strong></p> <p>Stakeholders include physicians ordering interventions required by VTE and HF Core Measures, nurses implementing and documenting these interventions, and quality nurses reviewing the ordering and documentation. Patients and healthcare leaders must also be included due to associated clinical and financial outcomes.</p> <p>The impact on efficiency of the audit for core measure compliance will be measured based on comparisons of time tests conducted before and after changes to the EMR have been made. Perceptions of system usability will be evaluated using pre and post implementation data from Brookes’ System Usability Scale.</p> <p><strong> </strong></p> <p> </p>