EHR System Transformation at Center of Penn Medicine Initiative

By Kate Monica

– Penn Medicine recently launched an initiative intended to transform EHR systems into more interactive, intuitive tools to ease provider burden, improve patient health outcomes, and boost clinical efficiency.

“We recognize that EHRs are no longer just part of how clinical care is documented, but they are central to how clinical care is delivered,” said University of Pennsylvania Health System Executive Vice President J. Larry Jameson, MD.

“Increasingly, health information technology plays a foundational role in each domain of our work: patient care, educating the next generation of physicians and scientists, and biomedical research,” he continued. “Electronic health records innovations are key to advancing our impact in each of those missions.”

Problems with EHR usability, clinical inefficiency, and administrative burden have retracted from the potential benefits of EHR use.

In some instances, poor EHR usability and high administrative burden have negatively affected patient care delivery. A 2018 JAMA study suggested problems with EHR usability may contribute to possible incidents of patient harm, while administrative burnout has been cited as a key contributor to rising rates of physician burnout.

Penn Medicine leadership is working directly with clinicians to make EHR systems more user-friendly and address these existing issues.

“We’re approaching this endeavor as if we were building a new clinical facility, laboratory, or training program: with a focus on the clinicians’ and patients’ needs,” said University of Pennsylvania Health System CEO Ralph W. Muller.

“Everything that shapes patient care should be designed to support the best possible outcomes. Electronic health records are a natural focus because they connect to everything we do,” Muller added.

Experts at Penn Medicine will make efforts to ensure clinicians are able to view relevant, actionable patient health information more quickly without sifting through large amounts of information.

The initiative will also target inefficiencies in clinical documentation. EHR data entry cuts significantly into the provider workday and can detract from the time clinicians spend interacting face-to-face with patients.

Clinicians at Penn Medicine have already taken steps to improve EHR design. Penn Medicine Center for Health Care Innovation Executive Director David Asch, MD, published research that suggested restructuring EHR systems to allow doctors to subscribe to their patients’ clinical information. Clinicians would receive real-time updates about patient health in a format that mirrors social media feeds.

Additionally, the Penn Medicine Nudge Unit has redesigned the health system’s EHR system to streamline patient referrals for cardiac rehabilitation, statin prescribing for cholesterol management, and advanced CT scan imaging.

“Ultimately, we need to move past the idea that the EHR is just an administrative tool, and see it as a clinical tool – like a scalpel, or a medication, or an X-ray machine,” Asch said. “We judge these tools by the degree to which they facilitate good patient care, and we should be judging the EHR against the very same standard.”

Finally, Penn has launched an innovation tournament to identify targets for EHR transformation. Teams of IT experts, data scientists, clinical educators, clinicians, and staff will work to develop and test EHR system improvements.

Clinical groups will also be encouraged to work together in “sprints” — or collaborative clinical groups — to streamline and improve EHR interactions and engagement with email and other digital mediums.

“Every day, we’re supporting, learning and running tests to investigate new ideas in the clinic, lab, and the classroom,” said Muller. “Our best ideas come from within our walls. With this initiative, the future of electronic medical records will be written by those working each day at Penn Medicine.”

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