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Appl Clin Inform 2024; 15(05): 928-938
DOI: 10.1055/s-0044-1790552
Research Article

Impact of a Disease-Focused Electronic Health Record Dashboard on Clinical Staff Efficiency in Previsit Patient Review in an Ambulatory Pulmonary Hypertension Care Clinic

Tapendra Koirala
1   Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, United States
,
Charles D. Burger
1   Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, United States
,
Rajeev Chaudhry
2   Department of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
,
Patricia Benitez
3   Department of Information Technology, Mayo Clinic, Rochester Minnesota, United States
,
Heather A. Heaton
4   Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, United States
,
Nilaa Gopikrishnan
1   Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, United States
,
Scott A. Helgeson
1   Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, United States
› Author Affiliations Funding None.
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Abstract

Objectives We aimed to improve the operational efficiency of clinical staff, including physicians and allied health professionals, in the previsit review of patients by implementing a disease-focused dashboard within the electronic health record system. The dashboard was tailored to the unique requirements of the clinic and patient population.

Methods A prospective quality improvement study was conducted at an accredited pulmonary hypertension (PH) clinic within a large academic center, staffed by two full time physicians and two allied health professionals. Physicians' review time before and after implementation of the PH dashboard was measured using activity log data derived from an EHR database. The review time for clinic staff was measured through direct observation, with review method—either conventional or newly implemented dashboard—randomly assigned.

Results Over the study period, the median number of patients reviewed by physicians per day increased slightly from 5.50 (interquartile range [IQR]: 1.35) before to 5.95 (IQR: 0.85) after the implementation of the PH dashboard (p = 0.535). The median review time for the physicians decreased with the use of the dashboard, from 7.0 minutes (IQR: 1.55) to 4.95 minutes (IQR: 1.35; p < 0.001). Based on the observed timing of 70 patient encounters among allied clinical staff, no significant difference was found for experienced members (4.65 minutes [IQR: 2.02] vs. 4.43 minutes [IQR: 0.69], p = 0.752), while inexperienced staff saw a significant reduction in review time after familiarization with the dashboard (5.06 minutes [IQR: 1.51] vs. 4.12 minutes [IQR: 1.99], p = 0.034). Subjective feedback highlighted the need for further optimization of the dashboard to align with the workflow of allied health staff to achieve similar efficiency benefits.

Conclusion A disease-focused dashboard significantly reduced physician previsit review time while that for clinic staff remained unchanged. Validation studies are necessary with our patient populations to explore further qualitative impacts on patient care efficiency and long-term benefits on workflow.

Keywords

electronic health records - disease-focused dashboards - previsit review - efficiency - workflow

Protection of Human and Animal Subjects

This study was deemed exempt from Institutional Review Board review for quality improvement purposes.


Supplementary Material



Publication History

Received: 27 March 2024

Accepted: 14 August 2024

Article published online:
06 November 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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