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

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-09

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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

Changes to search.HSLS.Clinical-e

Advisory Committee proposed◦ evaluate content, access

Seek outside funding to do validation study & content analysis

Promote/market/educate/train

Integrate into dbMotion interoperability

Next Steps

Questions ?

Health Sciences Library System University of Pittsburgh

www.hsls.pitt.edu