An EMR Pain Page That Works: Partnering With a National EMR Vendor

Topic: Leveraging Technology

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Outline:
I. Obstacle: Necessary patient events that support pain management are not in a consolidated view and require additional time to dig through the chart

II. Background:
a)      Palliative Care team Pre-Rounding
b)      Tiger Institute partnership, Established in 2009 between MU Health Care and Cerner Corporation
c)       Tiger Institute development team Innovation at the Edge partnered with MU Health Care Palliative Care providers to design a Pain Management Summary to aid in effective and efficient patient pain management

        1.1.   Description of page: Twelve-hour view of graphed pain events and vitals vertically aligned with full pain medication details table and pain events table

III. Study:
a)      Evaluating the four primary data elements that support pain management (Pain trend over 24 hours, pain medication over 24 hours, Stool, and Respiratory Rate)
b)      Time in Motion comparison between EMR standard tools and Pain Management Summary Page
c)   Task Load Index comparison between EMR standard tools and Pain Management Summary Page
d)      Participants:
1.1.   16 clinicians (attending physician, resident physician, medical student, registered nurse) evaluating 3 patients (6 total patients used)

IV. Results:
a) Total reduction in time to find primary pain data elements: - 54%
b) Reduction in time to find individual pain data elements:
1.1.   Pain medications administered in past 24 hours: - 65%
1.2.   Last stool: - 55%
1.3.   Respiratory rate: - 43%
1.4.   Pain score pattern for past 24 hours: - 51%

Author

  • Paul E. Tatum, III, MD
  • Program Director Hospice & Palliative Medicine Fellowship
  • University of Missouri-Tiger Institute
  • 1 Hospital Drive, M240, DC032.00
  • Columbia, MO 65065
  • (573) 999-0355

Co-authors

  • Elizabeth L Kiburz, BA, MBA, PMP
  • Hannah M. Tomlinson
  • Kasie D. Sly, BS
  • Kevin W. Craig, MD, MSPH, FAAFP
  • Mary M. Williamson, RN, BSN, OCN, NE-BC
  • Paul E Tatum, MD MSPH CMD FAAHPM AGSF
  • Tim Green, BS, PhD

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