Development of a Clinical Information Tool for the Electronic Health Record Barbara A. Epstein*, Nancy H. Tannery*, Charles B. Wessel*, Frances Yarger*, John LaDue*, Anthony Fiorillo + *Health Sciences Library System University of Pittsburgh +Ambulatory eRecord University of Pittsburgh Medical Center
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Barbara A. Epstein*, Nancy H. Tannery*, Charles B. Wessel*, Frances Yarger*, John LaDue*, Anthony Fiorillo + *Health Sciences Library System University.
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Development of a Clinical Information Tool for the Electronic Health Record
Barbara A. Epstein*, Nancy H. Tannery*, Charles B. Wessel*, Frances Yarger*, John LaDue*, Anthony Fiorillo+
*Health Sciences Library System University of Pittsburgh
+Ambulatory eRecord University of Pittsburgh Medical Center
Setting
How it started
Snapshot of what was developed
Timeline to EHR
Challenges and Next Steps
Outline
Large academic library serving University of Pittsburgh’s six health sciences schools, as well as the University of Pittsburgh Medical Center (UPMC)
UPMC hospitals contract with HSLS for access to licensed online resources.
Health Sciences Library System (HSLS)
UPMC comprises 20 tertiary, specialty, and community hospitals, 400 outpatient sites and doctors’ offices, and retirement and long-term care facilities.
eRecord has over 3 million unique patient records and more than 22,000 active users, including more than 5,000 physicians employed by or affiliated with UPMC.
More than 196 UPMC physician practices use eRecord.
UPMC
June 2004 – Library director invited to participate in the eRecord Physician Advisory Committee (PAC)
2004-2006 investigated various tools
MLA 2006 Phoenix ◦ Integrating Reference Information into the EHR –
Practices and Standards
How it started
Fall 2006 partnered with key physician from PAC
Library development team initiated to work with key physician
How it started
Identify appropriate technology
Identify full text information resources
Work with key physician to identify usability and work flow issues
Library development team
A meta-search engine that combines results from multiple sources into a single results list allowing users to search several resources at once
A search engine that clusters common terms from the results and creates “on the fly” groups to help narrow searches
Built on previous HSLS Vivisimo work
Technology -Vivísimo
Minimize dependence on any one resource
Take advantage of the wide variety of HSLS licensed resources
Find "the fewest number of resources that would still answer the questions"
Minimize repetition & redundancy
Resources
search.HSLS.Clinical-e
search.HSLS.Clinical-e
search.HSLS.Clinical-e
Key physician◦ Started with dx, disease and patient education
tabs Demo to IT Physician's Cabinet members
◦ EBM tab added; tab order changed Demo to Enterprise-Wide eRecord PAC
◦ Drug tab added; tab order changed Usability testing by volunteer group from
Enterprise-Wide eRecord PAC◦ Insert cursor in search box◦ Resources changed
Steps to EHR
Introduced into EHR October 2008"marriage of patient information/disease information"
Tab Usage by Month
Oct
ober
08
Novem
ber-0
8
Decem
ber-0
9
Janu
ary
09
Febu
ary
09
Mar
ch-0
9
April
-09
0
50
100
150
200
250
300
DDxDiseasesDrugsEBMPatient Ed
Shoestring funding & operations◦ Both good and bad
Scope of UPMC project dwarfs ours◦ Difficult to find the right people ◦ We are a very small part of a very large project
Working across 2 organizations ◦ No direct access to EHR
Challenges
Licensed resources added and removed
Tab changes
Reformatted search box on results page
Behind-the- scenes Java changes to accommodate EHR technology