Accurate problem lists 'critical' to EHR effectiveness

Providers need to make more effective use of patient problem lists in their electronic health records, according to speakers participating on a recent webinar sponsored by the U.S. Department of Health & Human Services Health Resources Services Administration.

Speaker Jerry Fingerut, medical director of Pawtucket, R.I.-based Blackstone Valley Community Healthcare, said that problem lists have been used by clinicians for decides, but provide many benefits when in an EHR, including improved clinical care, previsit planning, population management, quality improvement reporting, and Meaningful Use compliance. However, he said, in order to be fully effective, problem lists must be in a standardized, structured data format, as opposed to free text.

Electronic problem lists also need to be kept up to date, which isn't easy, added Jose Polanco, Blackstone's assistant medical director and CMIO. Polanco recommended that providers conduct periodic reviews of problem lists and train staff to keep them current. Organizations, he added, also should determine which clinicians need to be tasked with entering the problem list into the EHR. 

Other challenges to achieving the full benefit of electronic problem lists outlined by the speakers include list length, accessibility in the EHR, and ability to handle sensitive, confidential information.

Problem lists are an integral part of the Meaningful Use program, especially as it progresses beyond Stage 1, noted Michelle Consolazio, Meaningful Use Policy Analyst in the Office of the National Coordinator for Health IT's Office of the Chief Medical Officer.  A number of tools that ONC has developed for providers "start with problem lists" she said, including one involving workflows that is expected in July. She also stated that ONC's Health IT Policy Committee's recommendations for Stage 3, expected by October, will rely more heavily on the use and accuracy of problem lists.

To learn more:
- learn about the webinar