By: Dr. Scott Laing, PGY3 Clinician Scholar Program
Today many physicians are using electronic medical records (EMRs) in their practices. Although EMRs promise improved clinic efficiency by simplifying and automating tasks, many physicians are spending more time interacting with their computers than with their patients. This is particularly true when physicians need to extract multiple test results to help patients make informed decisions about their health. Preventive care is a common scenario where physicians need to extract many pieces of data from the EMR, which interferes with the patient-physician dynamics.
This project assesses a preventive care clinical decision aid that is integrated with the EMR. The decision aid automatically extracts the relevant age and sex appropriate preventive screening data and generates an overview to improve decision-making efficiency and accuracy. A pilot project tested this decision aid in a simulated clinical environment and showed faster chart review time. This saved time could then be used to spend longer discussing the screening with patients. The next steps will be using and assessing the decision aid in clinical practice, which is the basis of this study.
The goal is to improve patient health outcomes through screening, patient experience of care delivery, provider experience of care delivery, and to reduce per capita costs.
1. 2017 CMA Workforce Survey – Digital Health Results | Canada Health Infoway. https://www.infoway-inforoute.ca/en/component/edocman/resources/reports/benefits-evaluation/3362-2017-cma-workforce-survey-digital-health-results.
2. Telus Health. PS Suite Electronic Medical Record.
3. Wachter, R. M. Annals for Hospitalists Inpatient Notes - Hospitalists and Digital Medicine—Overcoming the Productivity Paradox. Ann. Intern. Med. 165, HO2 (2016).
4. Sinsky, C. et al. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann. Intern. Med. 165, 753 (2016).
5. Gawande, A. Why Doctors Hate Their Computers. (2018).
6. Joukes, E., Abu-Hanna, A., Cornet, R. & de Keizer, N. F. Time Spent on Dedicated Patient Care and Documentation Tasks Before and After the Introduction of a Structured and Standardized Electronic Health Record. Appl. Clin. Inform. 9, 46–53 (2018).
7. Kroth, P. J. et al. The electronic elephant in the room: Physicians and the electronic health record. JAMIA Open 1, 49–56 (2018).
8. Demanuele, F., Hines, R. M. & Walter, J. W. The Cumulative Patient Profile in Family Practice. Can. Fam. Physician 23, 41–44 (1977).
9. Shimizu, T., Bouchard, M. & Mavriplis, C. Update on age-appropriate preventive measures and screening for Canadian primary care providers. Can. Fam. Physician 62, 131–138 (2016).
10. Canadian Task Force on Preventive Health Care | Published Guidelines. https://canadiantaskforce.ca/guidelines/published-guidelines/.
11. Kruse, C. S. & Beane, A. Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review. J. Med. Internet Res. 20, e41 (2018).
12. Lewis, J. Cumulative Patient Profile. Can. Fam. Physician 35, 1259–1261 (1989).
13. Davis, F. D. Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology. MIS Q. 13, 319 (1989).
14. Campbell, S. M., Gately, C. & Gask, L. Identifying the patient perspective of the quality of mental healthcare for common chronic problems: a qualitative study. Chronic Illn. 3, 46–65 (2007).
15. Hirsch, A. G. et al. The electronic health record audit file: the patient is waiting. J. Am. Med. Inform. Assoc. 24, e28–e34 (2017).
16. Bodenheimer, T. & Sinsky, C. From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Ann. Fam. Med. 12, 573–576 (2014).