Background: Hospitalists spend a significant part of their workday interacting with the electronic medical record (EMR). Less is known regarding the details of the tasks that are performed during this interaction. In considering aspects of workflow and EMR usability, we sought to characterize how hospitalists spend time within the EMR, in terms of number of [...]

Background: Accurate problem lists linked to electronic medical record (EMR) clinical data can be useful for chart review by clinicians for patient care, clinical decision support design, and data extraction for clinical research.  The EMR at Stanford Hospital allows the problem list to be modified in several ways: adding and deleting problems, and designating problems [...]

Background: Inpatient physicians often discharge patients while diagnostic tests are still pending. The discharging attending is responsible for following-up these results, even if they have rotated off service. This can lead to delayed and/or missed detection of results, which impacts patient safety. It also creates a burden on physicians to check for results during time [...]

Background: Driven by meaningful use (MU) incentives, many safety net systems have adopted patient portals, which offer patients online access to their health information. Portal use correlates with increased engagement and better health outcomes, but there are many challenges to effectively engage patients and meet MU metrics in safety net settings. Purpose: We implemented a [...]

Background: Deployment of Electronic Medical Records (EMR) consumes significant enterprise-wide resources. Hospitals may be reluctant to introduce further changes during the same year, including patient experience improvement initiatives. Deployment efforts may stretch clinical leaders who provide oversight on patient experience efforts. Lastly, EMR is noted to be a major source of provider burnout and deployment [...]

Background: Transitions of care are critical to maintaining patient safety and decreasing adverse events, but they remain a complex process with many pitfalls. Electronic Medical Record (EMR) based handoffs can enhance communication by centralizing content for serial handoffs between providers, facilitating real-time updates and automatically incorporating patient data elements. Over the past several years, much [...]

Background: Studies have shown that care transitions represent times of great risk, especially to vulnerable patients; medication reconciliation is a major component of ensuring safe care transitions. Yet, challenges exist to obtaining a best possible home medication list (BPHML) on a provider, patient, and institutional level. Academic hospitals have large pools of in-training providers. Safety [...]

Background: Peripherally inserted central catheters (PICCs) are an increasingly popular choice in the acute care setting for intravenous therapy. However, compared to other catheters, PICCs are associated with a higher risk for venous thromboembolism and blood stream infection, with multi-lumen PICCs having higher complication rates than single lumen. Midline catheters are associated with a much [...]

Background: The EMR does not provide readily available information that conveys an at-a-glance understanding of discharge progress for a given patient. Healthcare workers have different workflows and need to manage the information in different ways, with a reliance on one-to-one conversations. We believe that optimizing patient length of stay is hindered by lack of: data [...]

Background: Typical solutions to incorporating provider input into discharge planning often rely on one-way communication mechanisms and data entry that is not dynamic (i.e. providers estimate day of discharge in advance). We are designing a discharge readiness tool to be integrated into our current electronic health record (EHR), Epic Systems-Verona Wisconsin, that allows providers to [...]