Open AccessCreation and implementation of an electronic health record note for quality improvement in pediatric epilepsy: Practical considerations and lessons learned
Author(s) -
Buchhalter Jeffrey R.,
Scantlebury Morris H.,
D’Alfonso Sabrina,
Appendino Juan Pablo,
Bello Espinosa Luis,
Brooks Brian L.,
Claassen Curtis,
Corbeil Jane,
Czank David,
Dean Stafford,
Ho Alice W.,
Jacobs Julia,
Mackay Maarit,
McMahon Joka,
Mineyko Aleksandra,
Rho Jong M.,
Roberts Trina,
Rothenmund Sonia,
Ruta Gary,
Sawchuk Tyson,
Simms Brett A.,
Smyth Kim,
Still Tammy,
Thornton Nancy
Publication year - 2021
Publication title -
epilepsia open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.247
H-Index - 16
ISSN - 2470-9239
DOI - 10.1002/epi4.12480
Subject(s) - documentation , informatics , health care , electronic health record , quality management , quality (philosophy) , medicine , family medicine , electronic data capture , medical emergency , population , health informatics , nursing , business , public health , clinical trial , computer science , philosophy , environmental health , engineering , service (business) , epistemology , marketing , pathology , electrical engineering , economics , programming language , economic growth
Objective To describe the development of the Pediatric Epilepsy Outcome‐Informatics Project (PEOIP) at Alberta Children's Hospital (ACH), which was created to provide standardized, point‐of‐care data entry; near‐time data analysis; and availability of outcome dashboards as a baseline on which to pursue quality improvement. Methods Stakeholders involved in the PEOIP met weekly to determine the most important outcomes for patients diagnosed with epilepsy, create a standardized electronic note with defined fields (patient demographics, seizure and syndrome type and frequency and specific outcomes‐ seizure type and frequency, adverse effects, emergency department visits, hospitalization, and care pathways for clinical decision support. These were embedded in the electronic health record from which the fields were extracted into a data display platform that provided patient‐ and population‐level dashboards updated every 36 hours. Provider satisfaction and family experience surveys were performed to assess the impact of the standardized electronic note. Results In the last 5 years, 3,245 unique patients involving 13, 831 encounters had prospective, longitudinal, standardized epilepsy data accrued via point‐of‐care data entry into an electronic note as part of routine clinical care. A provider satisfaction survey of the small number of users involved indicated that the vast majority believed that the note makes documentation more efficient. A family experience survey indicated that being provided with the note was considered “valuable” or “really valuable” by 86% of respondents and facilitated communication with family members, school, and advocacy organizations. Significance The PEOIP serves as a proof of principle that information obtained as part of routine clinical care can be collected in a prospective, standardized, efficient manner and be used to construct filterable process/outcome dashboards, updated in near time (36 hours). This information will provide the necessary baseline data on which multiple of QI projects to improve meaningful outcomes for children with epilepsy will be based.