Division of Rheumatology, Nationwide Children's Hospital, Columbus, Ohio, United States.
Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States.
Appl Clin Inform. 2022 Jan;13(1):180-188. doi: 10.1055/s-0041-1742219. Epub 2022 Feb 2.
We designed and implemented an application programming interface (API)-based electronic health record (EHR)-integrated rounding list and evaluated acceptability, clinician satisfaction, information accuracy, and efficiency related to the application.
We developed and integrated an application, employing iterative design techniques with user feedback. EHR and application user action logs, as well as hospital safety reports, were evaluated. Rounding preparation characteristics were obtained through surveys before and after application integration. To evaluate usability, inpatient providers, including residents, fellows, and attendings were surveyed 2 weeks prior to and 6 months after enterprise-wide EHR application integration. Our primary outcome was provider time savings measured by user action logs; secondary outcomes include provider satisfaction.
The application was widely adopted by inpatient providers, with more than 69% of all inpatients queried by the application within 6 months of deployment. Application utilization was sustained throughout the study period with 79% (interquartile range [IQR]: 76, 82) of enterprise-wide unique patients accessed per weekday. EHR action logs showed application users spent -3.24 minutes per day (95% confidence interval [CI]: -6.8, 0.33), = 0.07 within the EHR compared with nonusers. Median self-reported chart review time for attendings decreased from 30 minutes (IQR: 15, 60) to 20 minutes (IQR: 10, 45) after application integration ( = 0.04). Self-reported sign-out preparation time decreased by a median of 5 minutes ( < 0.01), and providers were better prepared for hand-offs ( = 0.02). There were no increased safety reports during the study period.
This study demonstrates successful integration of a rounding application within a commercial EHR using APIs. We demonstrate increasing both provider-reported satisfaction and time savings. Rounding lists provided more accurate and timely information for rounds. Application usage was sustained across multiple specialties at 42 months. Other application designers should consider data density, optimization of provider workflows, and using real-time data transfer using novel tools when designing an application.
我们设计并实现了一个基于应用程序编程接口（API）的电子病历（EHR）集成查房清单，并评估了其应用的可接受性、临床医生满意度、信息准确性和效率。
我们采用迭代设计技术和用户反馈开发并集成了一个应用程序。评估了 EHR 和应用程序用户操作日志以及医院安全报告。通过在应用程序集成前后进行调查获得了查房准备特征。为了评估可用性，在企业范围的 EHR 应用程序集成前两周和六个月后对住院医生进行了调查，包括住院医生、研究员和主治医生。我们的主要结果是通过用户操作日志衡量的提供者节省的时间；次要结果包括提供者满意度。
该应用程序被住院医生广泛采用，在部署后 6 个月内，应用程序查询了超过 69%的住院患者。在整个研究期间，应用程序的使用率保持稳定，每个工作日访问的企业范围内的独特患者为 79%（四分位距[IQR]：76，82）。EHR 操作日志显示，与非用户相比，应用程序用户在 EHR 中每天花费-3.24 分钟（95%置信区间[CI]：-6.8，0.33）。主治医生的自我报告图表审查时间中位数从应用程序集成前的 30 分钟（IQR：15，60）减少到 20 分钟（IQR：10，45）（ = 0.04）。自我报告的签名准备时间中位数减少了 5 分钟（ < 0.01），并且提供者在交接班时准备得更好（ = 0.02）。在研究期间没有增加安全报告。
本研究展示了使用 API 在商业 EHR 中成功集成查房应用程序。我们证明了提高提供者满意度和节省时间。查房清单为查房提供了更准确和及时的信息。该应用程序在 42 个月内得到了多个专业的持续使用。其他应用程序设计者在设计应用程序时应考虑数据密度、优化提供者工作流程以及使用实时数据传输使用新工具。
