EHRs enable new 'chart biopsies' to improve patient care before admission

EHRs can improve care coordination when admitting a patient from a hospital's emergency department by enabling the receiving physician to obtain patient information before the hand-off occurs, according to a study published recently in the Journal of the Medical Informatics Association.

The researchers, from Ohio State University and the University of Michigan, noted that coordination of care during patient transitions could be improved, but that most of the focus has been on the information transfer from the person handing off the patient. They suggested that the importance of the receiving party had been overlooked, and that EHRs could enable that person to obtain information about the patient before the hand-off to improve patient care.

The researchers conducted a two-year investigation at the University of Michigan Health System, using the data from 73 physicians. They found that the EHRs enabled the receiving physician to conduct a "chart biopsy" of the patient's medical record once the physician had been notified that the patient was being admitted from the ED, but before the hand off occurred.

The chart biopsy, which the researchers categorized as an emerging new step in care coordination, gave the receiving physician an overview of the patient, enabled the physician to prepare for the patient's care and reduced biases or mistakes made by the ED physicians.   

"Chart biopsy can enrich coordination and collaboration, improving the hospital's ability to act safely, efficiently, and effectively," the researchers said. They also noted that chart biopsies and other uses of EHRs that were not available with paper records can be used elsewhere, such as chart biopsies before daily rounds, and that these innovations could also positively impact hand-offs and EHR design.

Care coordination is a major tenet of the Meaningful Use incentive program, and the industry is striving to improve hand offs to improve patient care. The Joint Commission recently released a web-based care coordination tool to help pinpoint problems during patient hand offs and help to resolve them.  

To learn more:
- here's the study's abstract
- read about the Joint Commission tool

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