Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Clinical Applications, Centre for Addiction and Mental Health, Toronto, ON, Canada.
J Med Internet Res. 2021 May 20;23(5):e25656. doi: 10.2196/25656.
The delivery of standardized self-report assessments is essential for measurement-based care in mental health. Paper-based methods of measurement-based care data collection may result in transcription errors, missing data, and other data quality issues when entered into patient electronic health records (EHRs).
This study aims to help address these issues by using a dedicated instance of REDCap (Research Electronic Data Capture; Vanderbilt University)-a free, widely used electronic data capture platform-that was established to enable the deployment of digitized self-assessments in clinical care pathways to inform clinical decision making.
REDCap was integrated with the primary clinical information system to facilitate the real-time transfer of discrete data and PDF reports from REDCap into the EHR. Both technical and administrative components were required for complete implementation. A technology acceptance survey was also administered to capture physicians' and clinicians' attitudes toward the new system.
The integration of REDCap with the EHR transitioned clinical workflows from paper-based methods of data collection to electronic data collection. This resulted in significant time savings, improved data quality, and valuable real-time information delivery. The digitization of self-report assessments at each appointment contributed to the clinic-wide implementation of the major depressive disorder integrated care pathway. This digital transformation facilitated a 4-fold increase in the physician adoption of this integrated care pathway workflow and a 3-fold increase in patient enrollment, resulting in an overall significant increase in major depressive disorder integrated care pathway capacity. Physicians' and clinicians' attitudes were overall positive, with almost all respondents agreeing that the system was useful to their work.
REDCap provided an intuitive patient interface for collecting self-report measures and accessing results in real time to inform clinical decisions and an extensible backend for system integration. The approach scaled effectively and expanded to high-impact clinics throughout the hospital, allowing for the broad deployment of complex workflows and standardized assessments, which led to the accumulation of harmonized data across clinics and care pathways. REDCap is a flexible tool that can be effectively leveraged to facilitate the automatic transfer of self-report data to the EHR; however, thoughtful governance is required to complement the technical implementation to ensure that data standardization, data quality, patient safety, and privacy are maintained.
在心理健康领域，提供标准化的自我报告评估对于基于测量的护理至关重要。当将基于测量的护理数据采集的纸质方法输入到患者的电子健康记录 (EHR) 中时，可能会导致转录错误、数据缺失和其他数据质量问题。
本研究旨在通过使用专用的 REDCap（Research Electronic Data Capture；范德比尔特大学）实例来解决这些问题 - 这是一个免费的、广泛使用的电子数据采集平台，旨在为临床护理路径中数字化自我评估的部署提供便利，以为临床决策提供信息。
将 REDCap 与主要临床信息系统集成，以促进从 REDCap 实时传输离散数据和 PDF 报告到 EHR。完全实施需要技术和管理组件。还进行了一项技术接受度调查，以捕捉医生和临床医生对新系统的态度。
将 REDCap 与 EHR 集成将临床工作流程从基于纸张的数据采集方法转变为电子数据采集。这导致了显著的时间节省、数据质量的提高和有价值的实时信息传递。在每次预约时对自我报告评估进行数字化处理有助于在整个诊所范围内实施重度抑郁症综合护理路径。这种数字化转型促进了医生对这种综合护理路径工作流程的采用增加了 4 倍，患者参与度增加了 3 倍，导致重度抑郁症综合护理路径的能力显著提高。医生和临床医生的态度总体上是积极的，几乎所有受访者都认为该系统对他们的工作有用。
REDCap 为收集自我报告测量数据提供了直观的患者界面，并实时访问结果以做出临床决策，并且为系统集成提供了可扩展的后端。该方法有效地扩展到整个医院的高影响力诊所，允许复杂工作流程和标准化评估的广泛部署，从而导致诊所和护理路径之间的协调数据积累。REDCap 是一种灵活的工具，可以有效地利用它来促进自我报告数据自动传输到 EHR；然而，需要周到的治理来补充技术实施，以确保数据标准化、数据质量、患者安全和隐私得到维护。
