2009 Faculty Researchers

Karl Kochendorfer, MD

Improving Patient Care and Provider Efficiency with Innovative Tools within the Electronic Medical Record.

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Department

Family & Community Medicine

Office Location

MA241A Medical Sciences Building, DC032.00

Phone #:

Office: (573) 882-1213
Fax: (573) 882-9096

Summary

The increasing complexity of the health care system and pressure to see more patients faster creates problems in providing quality care for patients with chronic conditions as well as major issues in physician satisfaction. Clinicians frequently address more than one problem or chronic condition during a patient encounter. There are national treatment guidelines for most chronic conditions. Yet, according to a Rand study, clinicians only provide about 55% of the recommended treatment found within these national guidelines for any given chronic condition. Several innovative tools that work within the electronic medical record (EMR) have potential to increase physician efficiency and satisfaction while providing higher quality care. Up to three students could participate in the following projects.

Project #1
Studying physician use and satisfaction with web-based treatment guides (algorithms and calculators) that incorporate patient information from the EMR

We have developed web-based chronic disease treatment algorithms and have access to online calculators that can be accessed from a patient’s record and that automatically incorporates their specific clinical data. For example, for patients receiving anticoagulation therapy, relevant clincial data (INR level, current dose, other medical problems and medications) would be sent to an online warfarin dosing calculator, which would enable clinicians to seamlessly determine initial or subsequent dosing. Warfin is one of the highest risk medications and dose problems are common. The student would help design and implement a physician survey for use before and after introduction of this tool to assess its usefulness. Electronic measures of use and outcomes may also be feasible.

Project #2
Studying healthcare provider efficiency, satisfaction and patient care with an interactive, online, real-time rounding report within the EMR

Preliminary data has demonstrated that our paper-based rounding report has saved each resident physician over 40 minutes each day while working on the inpatient service within the University Hospital. An improved interactive, online, real-time version of the rounding report could demonstrate even greater gains among the clinicians and healthcare team treating our hospitalized patients. The student would help design and implement a healthcare provider survey for use before and after introduction of this tool to assess its usefulness. Electronic measures of use and outcomes may also be feasible.

Project #3
Studying the use of an electronic Mood Disorder Questionnaire (MDQ) within the EMR to screen for and detect Bipolar Disorder

Bipolar disorder afflicts over two million Americans and yet remains a highly under-diagnosed condition. There are estimates that only 20% of patients with the disorder actually receive the diagnosis of bipolar from their physician. This illness is associated with a significant mortality; as up to 20% of patients may commit suicide, many just as the depression lifts. The development of the Mood Disorder Questionnaire (MDQ) has been validated as an excellent tool to screen patients for the existence of a bipolar disorder quickly and easily. We have implemented an electronic version of the MDQ within the EMR to make this tool easier to implement in practice. The student would help design and implement a physician survey for use before and after introduction of this tool to assess its usefulness. Electronic measures of use and outcomes of any possible increased diagnosis of bipolar disorder will also be feasible.