High-performing healthcare organizations are moving beyond simply installing electronic medical records and digitizing clinical documentation. They should be looking to optimize their health IT now, as a Healthcare Information and Management Systems Society executive explained a few weeks ago.
That is what the chairman of neurology at Evanston, Illinois-based NorthShore University HealthSystem, is trying to do by customizing the Epic Systems EMR for his specialty.
“EMRs don’t meet the needs of neurological practice,” said Dr. Demetrius Maraganore, who also serves as medical director of NorthShore’s Neurological Institute and director of the Center for Brain Health. “These are major deficits in the EMR with respect to quality.”
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NorthShore’s neurology department teamed with the IT department and the four-hospital system’s Center for Biomedical Research Informatics to build structured clinical decision support toolkits into the Epic EMR that capture discrete data for 10 specific neurological disorders: brain tumors, epilepsy, migraine, memory disorders, mild traumatic brain injury, multiple sclerosis, neuropathy, Parkinson’s disease, restless leg syndrome, stroke, as well as for assessing brain health.
These tools produce what Maraganore called “perfectly spelled, perfectly paginated progress notes.” They also support clinical research, as Maraganore and a half-dozen NorthShore colleagues described in a paper in the October issue of the journal Neurology Clinical Practice.
Maraganore said that this customization addresses two gaps in current technology. “There are no well-established quality initiatives in outpatient neurology,” he said. “And there’s no way of comparing effective treatments in neurology.”
It’s unclear, for example, about what the quality guidelines are for movement disorders and no benchmark data for practices to compare their performance to, he explained. The toolkits add “precision” to the EMR for outpatient neurology. “We’re using the EMR to hard-wire best practices in neurology,” Maraganore said.
In June, after Neurology Clinical Practice accepted the paper, Maraganore received an Agency for Healthcare Research and Quality grant to create a consortium called the Neurology Practice-Based Research Network that would study the impact of these EMR tools on neurology care at eight health systems across the country, including NorthShore.
The two-year AHRQ grant calls for NorthShore to install as many as 10 toolkits, one for each disorder to be studied, in the EMRs of seven other institutions. The suburban Chicago system also will conduct pragmatic clinical trials for at least three of the 10 products, and Maraganore expects to have 10 the trials up and running within five years, even after the grant runs out.
The technology add-on could be expanded to other Epic users fairly easily, though Maraganore expects other users to share their data with NorthShore and the network for research purposes. He said his “long-term dream” is to capture and share common data regardless of the EMR vendor.
Photos: NorthShore University HealthSystem, Epic Systems
