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

Randi E Foraker, Bobbie Kite, Marjorie M Kelley, Albert M Lai, Caryn Roth, Marcelo A Lopetegui, Abigail B Shoben, Michael Langan, Nicole L Rutledge, Philip R O Payne, Randi E Foraker, Bobbie Kite, Marjorie M Kelley, Albert M Lai, Caryn Roth, Marcelo A Lopetegui, Abigail B Shoben, Michael Langan, Nicole L Rutledge, Philip R O Payne

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.

Keywords: Data visualization; Health information technology; Patient involvement.

Figures

Figure 1.
Figure 1.
CDS Alert: Data Sources, Risk Profiling and Visualization Engine, and Point-of-Care Delivery
Figure 2.
Figure 2.
Risk Calculation Algorithm Components: Summing by Variable Type and Selecting Visualization Color Scheme
Figure 3.
Figure 3.
SPHERE Tool (left) and Its Representation Alongside Other EHR Content (right)
Figure 4.
Figure 4.
Physical Activity and Diet Parameters: SPHERE Application
Figure 5.
Figure 5.
Pre- and Postimplementation CVH Data among 109 Women in Primary Care

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Source: PubMed

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