Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, United States.
Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, United States.
J Med Internet Res. 2021 Feb 12;23(2):e22939. doi: 10.2196/22939.
While electronic health records (EHR) bring various benefits to health care, EHR systems are often criticized as cumbersome to use, failing to fulfill the promise of improved health care delivery with little more than a means of meeting regulatory and billing requirements. EHR has also been recognized as one of the contributing factors for physician burnout.
Specialty-specific EHR systems have been suggested as an alternative approach that can potentially address challenges associated with general-purpose EHRs. We introduce the Epilepsy Tracking and optimized Management engine (EpiToMe), an exemplar bespoke EHR system for epilepsy care. EpiToMe uses an agile, physician-centered development strategy to optimize clinical workflow and patient care documentation. We present the design and implementation of EpiToMe and report the initial feedback on its utility for physician burnout.
Using collaborative, asynchronous data capturing interfaces anchored to a domain ontology, EpiToMe distributes reporting and documentation workload among technicians, clinical fellows, and attending physicians. Results of documentation are transmitted to the parent EHR to meet patient care requirements with a push of a button. An HL7 (version 2.3) messaging engine exchanges information between EpiToMe and the parent EHR to optimize clinical workflow tasks without redundant data entry. EpiToMe also provides live, interactive patient tracking interfaces to ease the burden of care management.
Since February 2019, 15,417 electroencephalogram reports, 2635 Epilepsy Monitoring Unit daily reports, and 1369 Epilepsy Monitoring Unit phase reports have been completed in EpiToMe for 6593 unique patients. A 10-question survey was completed by 11 (among 16 invited) senior clinical attending physicians. Consensus was found that EpiToMe eased the burden of care documentation for patient management, a contributing factor to physician burnout.
EpiToMe offers an exemplar bespoke EHR system developed using a physician-centered design and latest advancements in information technology. The bespoke approach has the potential to ease the burden of care management in epilepsy. This approach is applicable to other clinical specialties.
电子健康记录（EHR）为医疗保健带来了各种好处，但 EHR 系统常因其使用不便而受到批评，未能实现改善医疗服务的承诺，只不过是满足监管和计费要求的一种手段。EHR 也被认为是导致医生倦怠的因素之一。
专用 EHR 系统已被提议作为一种替代方法，可以解决通用 EHR 相关的挑战。我们引入了癫痫跟踪和优化管理引擎（EpiToMe），这是一个用于癫痫护理的专用 EHR 系统范例。EpiToMe 采用敏捷、以医生为中心的开发策略来优化临床工作流程和患者护理文档。我们介绍了 EpiToMe 的设计和实现，并报告了其在减轻医生倦怠方面的初步反馈。
使用与领域本体相关联的协作式、异步数据捕获接口，EpiToMe 将报告和文档工作负载分配给技术员、临床研究员和主治医生。文档的结果通过一键传输到主 EHR，以满足患者护理需求。一个 HL7（版本 2.3）消息传递引擎在 EpiToMe 和主 EHR 之间交换信息，优化临床工作流程任务，避免重复数据输入。EpiToMe 还提供实时、交互的患者跟踪界面，以减轻护理管理负担。
自 2019 年 2 月以来，EpiToMe 已为 6593 位独特患者完成了 15417 份脑电图报告、2635 份癫痫监测单元日常报告和 1369 份癫痫监测单元阶段报告。11 位（受邀的 16 位中的 11 位）资深临床主治医生完成了一份 10 个问题的调查。调查发现，EpiToMe 减轻了患者管理的护理文档负担，这是导致医生倦怠的一个因素。
EpiToMe 提供了一个使用以医生为中心的设计和信息技术最新进展开发的专用 EHR 系统范例。这种专用方法有可能减轻癫痫护理管理的负担。这种方法适用于其他临床专业。
