Surafel Tsega, M. Vijayaraghavan, Marianne Chronister, S. Srinivas, A. Bassily-Marcus, J. Gumprecht, Avniel Shetreat-Klein, Bruce Darrow, C. Craven
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The Chief Medical Information Officer launched a workgroup of clinical informaticists and Epic analysts tasked with rapidly creating COVID-19-related EHR tools for the inpatient setting.\n Results Initial EHR tools focused on inpatient order sets for care standardization and resource utilization. In preparation for a fall 2020-winter 2021 surge, we created a clinician-facing, integrated Care pathway incorporating additional Epic System-specific tools: a Care Path, a dedicated Navigator, Summary and Timeline Reports, and SmartTexts.\n Discussion Initial tools offered standard functionality but included complex decision-making support to account for the lack of COVID-19 clinical knowledge, operational challenges during a dramatic patient surge, and resource limitations. We revised content and built a more comprehensive Care pathway that provided real-time clinical data along with treatment recommendations as knowledge evolved, e.g., convalescent plasma.\n Conclusion We have provided a framework that can inform future informaticists in developing EHR tools during an evolving pandemic.","PeriodicalId":72041,"journal":{"name":"ACI open","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COVID-19 and the Electronic Health Record: Tool Design and Evolution at the U.S. Pandemic Epicenter\",\"authors\":\"Surafel Tsega, M. Vijayaraghavan, Marianne Chronister, S. Srinivas, A. Bassily-Marcus, J. Gumprecht, Avniel Shetreat-Klein, Bruce Darrow, C. 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引用次数: 0
摘要
我们详细介绍了西奈山卫生系统(Mount Sinai health system)创建的住院电子健康记录(EHR)系统工具,用于在美国震中纽约市的2019冠状病毒病(COVID-19)大流行初期的几个月里对患者进行临床管理。我们讨论了我们如何修改这些工具,以创建一个强大的护理途径,不像其他工具报道,帮助提供者照顾这些患者随着指南的发展。方法西奈山卫生系统于2020年3月8日成立指挥中心。首席医疗信息官成立了一个由临床信息学家和Epic分析师组成的工作组,其任务是为住院患者快速创建与covid -19相关的电子病历工具。结果最初的电子病历工具侧重于住院医嘱集,以实现护理标准化和资源利用。为了应对2020年秋季至2021年冬季的激增,我们创建了一个面向临床医生的综合护理路径,其中包括额外的Epic系统特定工具:护理路径、专用导览器、摘要和时间轴报告以及smartttext。最初的工具提供标准功能,但由于缺乏COVID-19临床知识、患者急剧增加期间的操作挑战以及资源限制,包括复杂的决策支持。我们修改了内容,建立了一个更全面的护理途径,随着知识的发展,提供实时临床数据和治疗建议,例如,恢复期血浆。我们提供了一个框架,可以为未来的信息学家在不断演变的大流行期间开发电子病历工具提供信息。
COVID-19 and the Electronic Health Record: Tool Design and Evolution at the U.S. Pandemic Epicenter
Objective We detail inpatient electronic health record (EHR) system tools created at Mount Sinai Health System for the clinical management of patients with coronavirus disease 2019 (COVID-19) during the early pandemic months in the U.S. epicenter, New York City. We discuss how we revised these tools to create a robust Care pathway, unlike other tools reported, that helped providers care for these patients as guidelines evolved.
Methods Mount Sinai Health System launched a Command Center on March 8, 2020. The Chief Medical Information Officer launched a workgroup of clinical informaticists and Epic analysts tasked with rapidly creating COVID-19-related EHR tools for the inpatient setting.
Results Initial EHR tools focused on inpatient order sets for care standardization and resource utilization. In preparation for a fall 2020-winter 2021 surge, we created a clinician-facing, integrated Care pathway incorporating additional Epic System-specific tools: a Care Path, a dedicated Navigator, Summary and Timeline Reports, and SmartTexts.
Discussion Initial tools offered standard functionality but included complex decision-making support to account for the lack of COVID-19 clinical knowledge, operational challenges during a dramatic patient surge, and resource limitations. We revised content and built a more comprehensive Care pathway that provided real-time clinical data along with treatment recommendations as knowledge evolved, e.g., convalescent plasma.
Conclusion We have provided a framework that can inform future informaticists in developing EHR tools during an evolving pandemic.