Getting Invited to the Table: Using Pilot Projects to Demonstrate Library Value
4:35 PM - 5:00 PM
Objective: We want to convince our stakeholders who are working on electronic health record (EHR) implementation to bring librarians to the table. We are seeking ways to integrate librarians into EHR implementation teams and demonstrate our value. We want to discover our constituents’ information needs and develop a pilot project or projects that can meet some of those needs.
Methods: Setting: We support a statewide network of hospitals and health sciences libraries. This network also supports our state’s federally funded Regional Extension Centers (REC). Exposures: We provided technical support in developing a pilot project to create an information portal to support clinical decision making. We worked with smaller community hospitals to streamline access to library resources using local EHR authentication systems. We provided support to our state’s REC consultants. After initial informal needs assessments with the REC consultants, we developed projects to facilitate the virtual collaborative work processes, which are essential in providing geographically dispersed professionals with the capability to provide ongoing support to primary care facilities. We also developed a project to track, analyze, synthesize, distribute, and archive access to key news, information, and documentation about EHR implementation through the federally funded stimulus programs.
Results and Conclusions: It is still too early to draw definitive conclusions about the impacts of our projects. The greatest need at this time was not so much for the provision of library resources through the EHR, but for assistance in managing the information needs surrounding implementation. Librarians should utilize skills in information seeking and organization. For librarians to facilitate information discovery and organization, we must first develop a fundamental understanding of the subject matter of this emerging domain. We need to be able to find relevant news, documentation, policies, and procedures. Once we assist in finding this information, our most critical role seems to be in organizing, archiving, and accessing this information. A whole new area of increasingly important gray literature is growing out of these projects, and the librarian’s value is greatly enhanced by our ability to help manage this new body of information.
Authors: Mary Beth Schell, Director, North Carolina Area Health Education Center Digital Library; Jim Curtis, Deputy Director; Adam Dodd, Web/Database Developer, North Carolina Area Health Education Center Digital Library; Health Sciences Library; University of North Carolina, Chapel Hill, NC
Invite Yourself to the Table: Librarians Contribute to Their Hospital System Electronic Medical Record
5:00 PM - 5:25 PM
Objective: To demonstrate that librarian involvement in electronic medical record (EMR) activities at Exempla Healthcare would promote the addition of evidence-based resources accessible from within an EMR and that EMR order sets developed for computerized provider order entry (CPOE) would be evidence based.
Methods: Librarians from Exempla Healthcare initiated contact with the chief medical information officer (CMIO) regarding evidence-based medicine (EBM) activities related to the pending EMR. Subsequently, the librarians have been involved in three specific initiatives to date. They were asked to provide comparative information on several products to assist in selecting a point-of-care resource to integrate into the EMR. The CMIO asked them to provide evidence as needed for the CPOE order sets being developed, and most recently the librarians were invited to participate along with clinicians representing the three hospitals on an evidence-based advisory committee (EBAC) organized by the CMIO. Purposes of the committee include improving quality of decisions where strong clinical evidence exists, addressing variation in practice patterns by examining the evidence, and promulgating EBM methodology throughout the system for use in decision making.
Results: The comparative information on point-of-care products provided by the librarians resulted in selection of a product to integrate into the EMR. When evidence was not easily available to add to the order sets, the librarians provided it. For the EBAC, the librarians have developed a structure for addressing the clinical questions and to date have provided evidence-based literature addressing five clinical questions. In addition to performing literature searches, the librarians participate in the discussions on changes to order sets. In some cases, order sets have been revised to reflect best evidence and references to the evidence is linked for provider education.
Conclusions: By initiating contact with the system CMIO, librarians have demonstrated that their knowledge and skills can contribute to the inclusion of evidence-based literature into the EMR and to the adoption of evidence-based methodologies throughout the hospital system.
Authors: Margaret M. Bandy, AHIP, FMLA, Manager, Library and Media Services, Exempla Saint Joseph Hospital, Denver, CO; Susan Brandes, Medical Librarian, Library Services, Exempla Good Samaritan Medical Center, Lafayette, CO; Karen K. Wells, Manager, Medical Library, Exempla Lutheran Medical Center, Wheat Ridge, CO
The Role of Clinical Decision Support in Improving the Safety, Quality, and Efficiency of Patient Care at Exempla Healthcare
5:25 PM - 5:50 PM
Description: In 2006, Exempla Healthcare selected Epic for their electronic medical record (EMR). The chief medical information officer recognized that clinical decision support (CDS) would be an essential component of a robust EMR that would contribute to patient care quality and safety. CDS was established in January 2009 to develop the tools needed by clinicians to make good decisions that lead to best possible outcomes. The speaker will describe tools such as alerts, reminders, and evidence-based order sets. She will address how computerized provider order entry (CPOE) works with the order sets and how CPOE development uncovered areas of clinical variation, leading to the creation of the Exempla Healthcare Evidence Based Advisory Council (EBAC) in August of 2010. The speaker will also explain what the EMR problem list is, why it is important, how it should be used, and how it is related to meaningful use. The speaker will also talk about working with Epic and a point-of-care product vendor to create links from the problem list to the product.
Authors: Terri Casterton, Electronic Medical Record Clinical Decision Support Application Coordinator, Exempla Healthcare, Denver, CO
