Embedding a State-Wide Prescription Drug Monitoring Program into the Electronic Health Record.

A new FHIR-based (fast healthcare interoperability resource), EHR-integrated (electronic health record) application was created that embeds directly into prescribers' workflows. The intervention automatically performs MME (morphine milligram equivalent) calculations, highlights unsafe thresholds, while also presenting controlled-substance medications each patient is using. Using this intervention, the number of clinicians who have checked a patient's controlled substance prescription data has increased 57.4%. The number of patients being checked increased by 9.2%. The number of opioid prescriptions written after checking the new interventions data increased from 9% to 14%. Integrating these data into the EHR has saved over 1600 hours of labor per year. This work has also led to accruing five bonus points from the Medicare promoting interoperability attestation program. This initiative, and others like it, have helped Intermountain Healthcare decrease controlled substance pills by nearly 11 million, in the past five years.

What Industry Wants: An Empirical Analysis of Health Informatics Job Postings.

OBJECTIVES: To describe the education, experience, skills, and knowledge required for health informatics jobs in the United States. METHODS: Health informatics job postings (n = 206) from Indeed.com on April 14, 2020 were analyzed in an empirical analysis, with the abstraction of attributes relating to requirements for average years and types of experience, minimum and desired education, licensure, certification, and informatics skills. RESULTS: A large percentage (76.2%) of posts were for clinical informaticians, with 62.1% of posts requiring a minimum of a bachelor's education. Registered nurse (RN) licensure was required for 40.8% of posts, and only 7.3% required formal education in health informatics. The average experience overall was 1.6 years (standard deviation = 2.2), with bachelor's and master's education levels increasing mean experience to 3.5 and 5.8 years, respectively. Electronic health record support, training, and other clinical systems were the most sought-after skills. CONCLUSION: This cross-sectional study revealed the importance of a clinical background as an entree into health informatics positions, with RN licensure and clinical experience as common requirements. The finding that informatics-specific graduate education was rarely required may indicate that there is a lack of alignment between academia and industry, with practical experience preferred over specific curricular components. Clarity and shared understanding of terms across academia and industry are needed for defining and advancing the preparation for and practice of health informatics.

Developing and Validating a Model for Detecting Longitudinal Inconsistencies in the Electronic Problem List.

Clinicians from different care settings can distort the problem list from conveying a patient's actual health status, affecting quality and patient safety. To measure this effect, a reference standard was built to derive a problem-list based model. Real-world problem lists were used to derive an ideal categorization cutoff score. The model was tested against patient records to categorize problem lists as either having longitudinal inconsistencies or not. The model was able to successfully categorize these events with ~87% accuracy, ~83% sensitivity, and ~89% specificity. This new model can be used to quantify intervention effects, can be reported in problem list studies, and can be used to measure problem list changes based on policy, workflow, or system changes.

Electronic problem lists: a thematic analysis of a systematic literature review to identify aspects critical to success.

Objective: Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians' perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record. Materials and Methods: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to systematically curate a corpus of pertinent articles. We performed a thematic analysis, looking for interesting excerpts and ideas. By aggregating excerpts from many authors, we gained broader, more inclusive insights into what makes a good problem list and what factors are conducive to its success. Results: Analysis led to a list of 7 benefits of using the problem list, 15 aspects critical to problem list success, and knowledge to help inform policy development, such as consensus on what belongs on the problem list, who should maintain the problem list, and when. Conclusions: A list of suggestions is made on ways in which the problem list can be improved to increase utilization by clinicians. There is also a need for standard measurements of the problem list, so that lists can be measured, compared, and discussed with rigor and a common vocabulary.

Patterns and Perceptions of Asynchronous Video Discussion in a Graduate Health Sciences Course.

BACKGROUND: Studies of graduate online education indicate a need for increased interaction among students and faculty. However, it can be challenging to foster a high level of scholarly interaction and engagement in fully online courses. The objective of this study was to evaluate student perceptions and participation patterns related to online, asynchronous video discussion in a graduate health sciences course. METHOD: An asynchronous video discussion was piloted in a 2014 interprofessional informatics course and students were subsequently surveyed to determine their perceptions of this approach. Participation patterns were analyzed using descriptive statistics and social network analysis. RESULTS: The results indicate broad and inclusive interaction among students and faculty, with discussion characteristics perceived as equivalent to, or better than, traditional classroom discussion. The quality of student participation was high, and students spent additional time researching and preparing their contributions. CONCLUSION: This format for a seminar-style discussion holds good potential for effective teaching and learning in online graduate-level health courses and supports the development of students' critical thinking and scholarly communication skills. [J Nurs Educ. 2016;55(12):706-710.].

Problem management module: an innovative system to improve problem list workflow.

Electronic problem lists are essential to modern health record systems, with a primary goal to serve as the repository of a patient's current health issues. Additionally, coded problems can be used to drive downstream activities such as decision support, evidence-based medicine, billing, and cohort generation for research. Meaningful Use also requires use of a coded problem list. Over the course of three years, Intermountain Healthcare developed a problem management module (PMM) that provided innovative functionality to improve clinical workflow and boost problem list adoption, e.g. smart search, user customizable views, problem evolution, and problem timelines. In 23 months of clinical use, clinicians entered over 70,000 health issues, the percentage of free-text items dropped to 1.2%, completeness of problem list items increased by 14%, and more collaborative habits were initiated.