Impact of Meaningful Use on Clinical Workflow in Emergency Departments (New York)

Project Details - Ongoing

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Summary:

Advances in electronic health records (EHRs) can improve quality, safety, and efficiency of health care. Federal incentives have stimulated the adoption of EHRs and stages of “meaningful use” (MU) implementation have been established. As EHRs become even more prevalent, measuring acceptability to users and impact on clinical workflow is increasingly important. Early reports from hospitals and governing bodies experienced with Stage 1 MU implementation have called for external evaluation of MU criteria before implementing future stages.

This longitudinal study will investigate the impact of MU on clinical workflow. Data sources for this research include environmental observations, clinician shadowing, EHR logfiles, and radio frequency identification sensor-based tracking. The study will assess the contribution of MU on patient safety and quality of care. Additionally, it will identify causes of workflow bottlenecks and strategies for mitigation. The research will be conducted at two emergency departments (EDs) that care for different patient populations and have varied EHR MU strategies.

The specific aims of this project are as follows:

  • To investigate patterns of clinicians’ use of an EHR within the ED with specific emphasis on clinical workflow and decisionmaking while the organization is seeking to comply with Stage 2 MU criteria. 
  • To evaluate how a set of five clinical quality and efficiency metrics change during the course of Stage 2 implementation and to trace the contribution of the changes in the metrics to the aspects of clinical workflow. 
  • To develop contextually plausible and relevant patient safety and quality guidelines for EHR improvement that may be suitable for incorporation into future MU stages. 

Findings from this project will contribute to the development of patient safety and quality guidelines for EHR improvement. The results will also provide evidence-based guidance for certification criteria for EHR vendors and future regulations promoting meaningful use of EHRs.

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