{"id":5623,"date":"2018-01-15T14:55:19","date_gmt":"2018-01-15T19:55:19","guid":{"rendered":"https:\/\/michigan.it.umich.edu\/news\/?p=5623"},"modified":"2024-07-08T06:06:06","modified_gmt":"2024-07-08T10:06:06","slug":"ehr-prompts","status":"publish","type":"post","link":"https:\/\/michigan.it.umich.edu\/news\/2018\/01\/15\/ehr-prompts\/","title":{"rendered":"EHR prompts improve chronic disease management and preventive care"},"content":{"rendered":"

\"Doctor<\/p>\n

Something exciting is happening at Michigan Medicine. And U-M patients are benefiting.<\/span><\/p>\n

In recent months, the screening rate for depression symptoms in patients who had diagnosis of depression in last 12 months rose from 10 percent to nearly 70 percent. The rate of lung cancer screenings in smokers doubled. And the <\/span>hepatitis C screening rate improved fivefold among Baby Boomers<\/span><\/a>, as well as increase follow specialty care for infected patients.<\/span><\/p>\n

These are just some of the improvements largely attributed to <\/span>clinical decision support, or CDS, a key functionality of health information technology delivered through the <\/span>electronic health record (EHR), MiChart<\/span>. When applied effectively, CDS increases care quality, enhances health outcomes, helps avoid errors, improves efficiency, reduces costs, and boosts provider and patient satisfaction.<\/span><\/p>\n

David Serlin M.D., assistant professor of Family Medicine, said he finds CDS incredibly helpful. \u201cIn primary care, we are responsible for 42 quality metrics. It can be hard to remember which of the 42 a patient needs in any given situation. (CDS) reminds us what patients are due for in a 20-minute office visit.\u201d<\/p>\n

CDS benefits both chronic disease management and preventive care. During a diabetic patient\u2019s appointment, her care team may be prompted to do a foot exam, eye exam, urine screen, sugar check, and medication review. They may also receive a prompt if the patient is due for a Pap smear or mammogram.<\/span><\/p>\n

Providers across the country are under an increasingly heavy workload. That\u2019s in part due to changes in reimbursement as well as an explosion of medical knowledge. Healthcare is transitioning to value-based reimbursement, which is determined by a combination of cost and quality measure performance.<\/p>\n

\u201cWhile <\/span>there is a lot of money riding on quality of care, the bottom line is it\u2019s the right thing to do for our patients,\u201d Serlin said. \u201cIf we do this right, the health system brings in more money, patients have better outcomes, and (providers) benefit from the satisfaction of providing good care and bringing in more revenue to support our clinical infrastructure.\u201d<\/span><\/p>\n

Cheryl Dehmlow, one of the analysts working on population health management in Health Information Technology & Services (HITS), focuses on clinical decision support for preventive care and chronic disease management in ambulatory care.<\/span><\/p>\n

\u201cThe role of clinical decision support is to offer cues of what the patient is due for and make it very easy for the provider or care team to take the next step to help the patient fulfill those needs,\u201d said Dehmlow. \u201cThe EHR alerts are not the decision, they\u2019re the support. They do not require a provider or care team to do anything. They simply assist their decision making.\u201d<\/span><\/p>\n

There are four primary types of CDS: best practice alerts (BPAs), health maintenance (viewed in MiChart and delivered to patients through the patient portal), panel quality dashboards (reports that show which patients are overdue for standard preventative care or disease management), and drug-drug\/drug-allergy alerts (<\/span>when a prescribed <\/span>drug interacts with another drug or allergy listed in the patient\u2019s chart).<\/p>\n

\u201cI don\u2019t approach CDS in terms of what the technology can do. I want to understand the clinical objective and who are the clinical support users who naturally play a role in meeting that objective so we can help assess if \u2013 and what kind of \u2013 CDS is the right intervention,\u201d Dehmlow said.<\/span><\/p>\n

Population management clinical decision support is guided by the \u201cCDS Five Rights\u201d to ensure the right <\/span>information<\/b> is provided, to the right <\/span>people<\/b>, in the right intervention <\/span>format<\/b>, through the right <\/span>channel<\/b>, at the right <\/span>time<\/b>.<\/span><\/p>\n

This is key to physicians like Greta Branford, M.D.<\/span><\/p>\n

\u201cProviders tend to have a love\/hate relationship with CDS,\u201d said Branford, instructor in Internal Medicine and Pediatrics and Communicable Diseases and Associate Chief Medical Information Officer. \u201cWe hate to be stopped in our tracks and don\u2019t like interruptions, but at the same time if the alerts are reliable, predictable, and provide a good reminder, we trust them and they become very useful.\u201d<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Something exciting is happening at Michigan Medicine. And U-M patients are benefiting. In recent months, the screening rate for depression symptoms in patients who had diagnosis of depression in last 12 months rose from 10 percent to nearly 70 percent. The rate of lung cancer screenings in smokers doubled. And the hepatitis C screening rate improved fivefold among\u2026 Read More »<\/a><\/span><\/p>\n","protected":false},"author":28,"featured_media":5989,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_umich_oidc_access":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_ef_editorial_meta_date_first-draft-date":"1515110400","_ef_editorial_meta_paragraph_assignment":"","_ef_editorial_meta_checkbox_needs-photo":"1","_ef_editorial_meta_number_word-count":"","footnotes":""},"categories":[4],"tags":[70,176,51],"class_list":["post-5623","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-features","tag-health","tag-hits","tag-medical"],"uagb_featured_image_src":{"full":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-e1513100820800.jpg",600,399,false],"thumbnail":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-125x83.jpg",125,83,true],"medium":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-300x200.jpg",300,200,true],"medium_large":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-768x510.jpg",665,442,true],"large":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-700x465.jpg",600,399,true],"1536x1536":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-e1513100820800.jpg",600,399,false],"2048x2048":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-e1513100820800.jpg",600,399,false],"excerpt-thumbnail":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-200x140.jpg",200,140,true],"themonic-thumbnail":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-60x42.jpg",60,42,true],"ioslider-thumbnail":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-658x300.jpg",658,300,true],"post-thumbnail":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-665x442.jpg",665,442,true],"400x250-crop":["https:\/\/michigan.it.umich.edu\/news\/wp-content\/uploads\/2017\/12\/DSC_0120-1-e1513100820800.jpg",376,250,false]},"uagb_author_info":{"display_name":"Heather Kipp, HITS Communications","author_link":"https:\/\/michigan.it.umich.edu\/news\/author\/hengeshl\/"},"uagb_comment_info":0,"uagb_excerpt":"Something exciting is happening at Michigan Medicine. And U-M patients are benefiting. In recent months, the screening rate for depression symptoms in patients who had diagnosis of depression in last 12 months rose from 10 percent to nearly 70 percent. The rate of lung cancer screenings in smokers doubled. And the hepatitis C screening rate…","_links":{"self":[{"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/posts\/5623","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/comments?post=5623"}],"version-history":[{"count":10,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/posts\/5623\/revisions"}],"predecessor-version":[{"id":7010,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/posts\/5623\/revisions\/7010"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/media\/5989"}],"wp:attachment":[{"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/media?parent=5623"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/categories?post=5623"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/michigan.it.umich.edu\/news\/wp-json\/wp\/v2\/tags?post=5623"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}