Adoption of EHRs helps physicians to get up to speed on incoming patients before handoffs from the emergency department.
As the number of hospitals with electronic health record systems grows, a new study finds that inpatient physicians who receive patients from the emergency department have begun to do “chart biopsies” of electronic records to prepare for the handoffs.
Although the study in the Journal of the American Medical Informatics Association (JAMIA) doesn’t reach any conclusions about whether chart biopsies are an improvement over traditional handoff methods, it points outs that “chart biopsies appear to impact important clinical and organizational processes. Among these are the nature and quality of handoff interactions and the quality of care.”
The study defines a chart biopsy as “the activity of examining a patient’s health record to orient oneself to the patient and the care that the patient has received in order to inform subsequent conversations about or care of the patient.” To understand how this process works, the researchers studied general internal medicine physicians and surgeons who received patients from the ED at the University of Michigan Health System (UMHS) for a two-year period.
At UMHS, hospital physicians had access to two EHRs: one was for inpatient and outpatient documentation, and the other was used in the ED. When ED doctors and nurses entered data into their EHR, the inpatient doctors could view that data immediately. Over time, they began to review the ED charts before having a conversation with the ED physician who admitted the patient.
The three main functions of chart biopsies, according to the study, are getting an overview of the patient, preparing for handoff and subsequent care, and defending against potential biases.
According to Hilligoss, every UMHS physician that he observed did some kind of chart biopsy. But they didn’t do one in every case–sometimes they were too busy–and every doctor did them differently. Hilligoss did point out, however, that doctors in hospitals other than UMHS were also starting to perform chart biopsies; fellow academics at other institutions have told him this. “It isn’t something that anyone has preplanned for, but because the EHR is there, they’re naturally doing it,” he said.
Source: www.informationweek.com; Ken Terry; September 17, 2012.