Electronic health documentation offers critical value to healthcare delivery, including increased legibility and comprehensiveness and improved access. However, the EHR drives time-consuming workflows and makes the wealth of information in a single patient’s chart too extensive for a clinician to read, digest, and act on. A modern patient record normally contains thousands of lines of text—more than the disk drive of the computers that housed the first EHRs.
While digitized patient records are cumbersome, they pave the way for more advanced technology to further improve efficiency and care. Automation of routine, repeatable tasks, paired with curation of the most important information in the chart, allows providers to benefit from diligent, digitized documentation. As the Office of the National Coordinator for Health Information Technology (ONC) works to establish a policy and development agenda around workflow automation through the use of modern computing, solutions that aid processes while maximizing data value are increasingly important.
Fortunately, the healthcare digital environment today makes effective data curation achievable. World- class digital platforms can surface the appropriate insights from terabytes of data into an actionable recommendation by leveraging rules engines and advanced analytic capabilities to automate the EHR workflow. Great technology can find the proverbial diamond, in the deep mines of EHR data.
Like unlocking a door, an automated EHR workflow “key” allows clinicians to access the intelligence in healthcare’s vast data stores. That key, or solution, is comprised of automated capabilities that provide the right insight to the right person at the point of care (the right place).
For optimal outcomes, evidence-based medicine must drive clinical decision support. However, clinicians can’t realistically memorize the best protocol for every medication, reaction to every lab result, or care plan for every chronic condition. Recommendations evolve daily, and it takes a dedicated team or system to develop the right insights and present them to the appropriate staff.
In response, analytics vendors have developed pre-built rules engines that fully integrate into the EHR. These rules engines can take into account overall utilization, cost, charges, recent activity, and more to determine the individual caregiver or location with overall accountability for the health of a given patient, eliminating the building and maintenance demands on users while unlocking more of the patient’s health record.
Ultimately, insights must reach the team member who can take action and get the patient needed care. The right person is a member of the care team who can act on a recommendation from the EHR and communicate the next steps with the patient and the facilities involved (e.g., radiology or a lab). For example, if a patient needs an HbA1c reading, that information must route to a member of the care team who can order the test and direct the patient to the lab. The reading shouldn’t go to the patient’s physical therapist, for instance, simply because they happened to open the patient’s chart.
To ensure information reaches the right person, a robust, interoperable data platform (e.g., the Health Catalyst Data Operating System (DOS™) embeds comprehensive data directly into existing visit and ordering workflows. As a result, information appears in programs, dashboards, etc., where the appropriate users are already working. Embedding insights into existing workflows for the right people eliminates “click outs” (clicking something that takes the user out of their current application) and puts the information in a convenient place to get the best results.
Clinicians and staff spend the majority of the workday logged into the EHR, making it the right place to assess critical information. Serving insights in a clear, actionable, and transparent manner within the EHR workflow helps reduce the risk that end users will overlook important data or miss it among the hundreds of buttons, menus, navigators, and text boxes also covering a clinician’s computer screen.
If the clinician is planning for medications, the insights for patient monitoring need to be on the order form. If providing instructions for discharge, the instructions need to pop into the after visit summary. And, if planning for an office visit, the information needs to be in those visit notes so care teams can’t miss them.
For example, Healthfinch® by Health Catalyst: Charlie™ for Refill Management automates medication renewal decision support directly in the EHR workflow. When a renewal request is received, Charlie for Refill Management reviews the patient chart for relevant data, compares it against more than 1,000 protocols to determine whether the request is safe to renew, then summarizes data from the patient’s chart and recommends next steps (e.g., approve the renewal, follow up with the patient to close care gaps, etc.).
Existing healthcare data and analytics technology can mine the data platform and bring the value of digital documentation directly to team members. With proper tools in place (e.g., a data platform and rules engines), the right insights make it to the right person at the right time and place, thereby improving the healthcare experience for care teams, health systems, and patients.
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