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Tytuł:
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Translating electronic health record-based patient safety algorithms from research to clinical practice at multiple sites.
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Autorzy:
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Zimolzak AJ; Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas, USA.; Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Singh H; Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas, USA.; Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Murphy DR; Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas, USA.; Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Wei L; Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas, USA.; Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Memon SA; Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas, USA.; Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Upadhyay DK; Division of Quality, Safety and Patient Experience, Geisinger, Danville, PA, USA.
Korukonda S; Research Institute, Geisinger, Danville, PA, USA.
Zubkoff L; Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama, USA.; Division of Preventive Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Sittig DF; School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas, USA .
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Źródło:
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BMJ health & care informatics [BMJ Health Care Inform] 2022 Jul; Vol. 29 (1).
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BMJ Publishing, [2019]-
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MeSH Terms:
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Electronic Health Records*
Patient Safety*
Algorithms ; Documentation ; Humans
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References:
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BMJ Open. 2019 Dec 31;9(12):e033962. (PMID: 31892667)
Ann Intern Med. 2018 Jun 5;168(11):832-833. (PMID: 29404569)
J Am Med Inform Assoc. 2009 Sep-Oct;16(5):624-30. (PMID: 19567788)
J Am Med Inform Assoc. 2016 Nov;23(6):1046-1052. (PMID: 27026615)
BMJ Qual Saf. 2014 Jan;23(1):8-16. (PMID: 23873756)
Acad Med. 2020 Aug;95(8):1172-1178. (PMID: 31688035)
Diagnosis (Berl). 2020 Jul 24;8(1):51-65. (PMID: 32706749)
Nature. 2010 Oct 14;467(7317):753. (PMID: 20944687)
BMJ Qual Saf. 2019 Feb;28(2):151-159. (PMID: 30291180)
Radiology. 2015 Oct;277(1):81-7. (PMID: 25961634)
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Grant Information:
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R01 HS027363 United States HS AHRQ HHS
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Contributed Indexing:
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Keywords: Electronic Health Records; Health Services Research; Medical Informatics; Patient Care
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Entry Date(s):
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Date Created: 20220719 Date Completed: 20220720 Latest Revision: 20220803
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Update Code:
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20240104
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PubMed Central ID:
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PMC9289019
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DOI:
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10.1136/bmjhci-2022-100565
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PMID:
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35851287
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Introduction: Researchers are increasingly developing algorithms that impact patient care, but algorithms must also be implemented in practice to improve quality and safety.
Objective: We worked with clinical operations personnel at two US health systems to implement algorithms to proactively identify patients without timely follow-up of abnormal test results that warrant diagnostic evaluation for colorectal or lung cancer. We summarise the steps involved and lessons learned.
Methods: Twelve sites were involved across two health systems. Implementation involved extensive software documentation, frequent communication with sites and local validation of results. Additionally, we used automated edits of existing code to adapt it to sites' local contexts.
Results: All sites successfully implemented the algorithms. Automated edits saved sites significant work in direct code modification. Documentation and communication of changes further aided sites in implementation.
Conclusion: Patient safety algorithms developed in research projects were implemented at multiple sites to monitor for missed diagnostic opportunities. Automated algorithm translation procedures can produce more consistent results across sites.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
