Abstract: This panel will present the results of an AHRQ funded project to define, model, and validate the characteristics of clinician-defined electronic health record (EHR) functionality. Using complex simulated inpatient and outpatient cardiovascular patient scenarios, we defined the transactions, workflows, data flows, information management streams, operational characteristics and logistical interactions required to manage these simulated cases at 8 institutions (4 academic and 4 private practice). A prototype EHR was created and iterated upon via agile and user-centered design principles to evaluate and model approaches to the optimized EHR. The prototype was then evaluated across the 8 participating institutions and compared to their installed EHR. Results: Based on the System Usability Survey (SUS), the clinician-centered prototype EHR scored significantly higher than the installed EHR (77.8 versus 48.1, p<0.0001). The panel will review the qualitative results of the 60 clinician interviews, the deconstructed clinical framework that allowed us to construct the prototype EHR, and the functionality of the framework via the prototype EHR. Critically, this study elucidates the framework for the efficient, effective and satisfying EHR of the future.

Describe the new knowledge and additional skills the participant will gain after attending your presentation.: Clinical care is practiced the same across the country and is independent of installed EHR, therefore best practices in EHR implementation can be established. Clinicians want good data pushed to them, and easy access to good patient narratives. They want intuitive support for documentation and ordering. They also want to eliminate “impertinent negatives” and note bloat. User-centered design can be a powerful tool to reduce clinician burn-out without sacrificing quality and patient safety.

Authors:

John Windle (Presenter)
University of Nebraska Medical Center

Thomas Windle (Presenter)
University of Nebraska Medical Center

Martina Clarke (Presenter)
University of Nebraska Medical Center

James Tcheng (Presenter)
Duke University