Practically Speaking
Winter 2018

Panel members discuss implementing clinical pathways in EHRs: Keith Horvath, MD, AAMC; Marc Overhage, MD, PhD, Cerner; Kathleen McGroddy Goetz, PhD, IBM Watson; Christopher Alban, MD, Epic; Peter Eckart, MA, Data Across Sectors for Health (DASH)

Using EHRs in Research Summit with AAMC

In its efforts to provide additional support to grantees, Donaghue joined with AAMC to host “The Current State and Future Vision: Making EHRs Work for You” summit at the AAMC Learning Center in Washington D.C. this past October.

The summit brought together approximately eighty participants, among them chief medical officers, chief information officers, chief quality officers, leading researchers from health systems, along with representatives from government agencies, nonprofit organizations, and foundations to identify opportunities for improving the EHR function that support the advancement of learning health systems.

This summit was developed as a component of the Donaghue-AAMC partnerships that supports research on learning health systems and academic-community efforts to improve population health. Several Donaghue grantees from this and other programs attended the summit.

The summit opened with researchers from three different health systems sharing their experience using health informatics to conduct innovative and interdisciplinary studies. Jeffery Gold, MD, highlighted the value of adopting an EHR simulation tool to evaluate and train healthcare professionals while identifying safety and processing errors in EHR use. Jeffery Kullgren, MD, resented how analyzing EHR orders can help identify where low-value services are ordered and provide opportunities in facilitating high-value healthcare decision-making. Simon Mahler, MD, introduced an EHR tool, the HEART Pathway, which identifies patients eligible for early discharge from emergency departments. He also described a related app that offers a scalable solution and EHR integration.

Next, participants heard from Christopher J. Alban, MD, MBA, from Epic and Bharat Sutariya, MD, from CERNER who each shared their perspectives on the capabilities and goals of future systems. Vivian Singletary, MBA, provided an overview of Digital Bridge, a partnership among healthcare and public health organizations that are implementing electronic case reporting across the country. David Grabowski, PhD, then discussed the importance of EHR linkage with post-acute care and long-term care systems. He identified the barriers to achieving inter-operability and discussed policy options moving forward.

Summit attendees had the opportunity to discuss and debate what issues related to EHR research and analysis they found most relevant to advancing learning health systems. After working in small groups, attendees posed questions to an expert panel, which included earlier speakers and Kathleen McGroddy-Goetz, PhD from IBM Watson; Peter Eckart, MA, Illinois Public Health Institute and Co-Director, Data Across Sectors for Health (DASH); and Joshua M. Sharfstein, MD, Bloomberg School of Public Health.

The following themes emerged as areas of focus moving forward as AAMC works with health systems to identify best practices related to EHR implementation and using EHR data for research:

  • Adopting and optimizing clinical decision support systems;
  • Engaging clinician and others in optimization and identifying data needs;
  • Incorporating additional data into EHRs such as social determinants of health and patient-reported data;
  • Transferring knowledge across institutions about effective EHR-tools, resources, governance structures, and data models;
  • Standardizing outcome measures in EHRs to support interoperability.

With the summit as a kick-off, AAMC launched the EHR optimization discussion group, which is composed of leaders from academic health systems, the research community, and EHR vendors who are dedicated to identifying best practices in EHR implementation and performance improvement. AAMC will lead this group when gathering best practices related to the themes that emerge from the summit and when developing policy papers and advocating for issues related to EHR optimization within learning health systems.

Nancy Yedlin, Donaghue Vice President, worked with Alex Ommaya, AAMC’s Director of Clinical Effectiveness and Implementation Research, to develop the summit goals and agenda. “This meeting is an example of the efforts that Donaghue is undertaking to provide assistance to our grantees beyond grant dollars. We were hearing from our grantees how integral the EHR is to their work and about the opportunities as well as challenges these systems present for conducting research. The collaboration with the AAMC on the summit brought researchers together with other key voices in the field. The AAMC can build on that to support our grantees and many other researchers. We’re looking forward to developing other opportunities to highlight the important research that is done by our awardees and to lend our support.”

You can get more information about AAMC’s EHR Optimization Discussion group by contacting Anne Berry
(aberry@aamc.org).