Our institution uses Epic as its electronic medical record (EMR), and managing the complex needs of OPAT patient’s has been challenging and also time-consuming with our EMR. It became imperative that the EMR be modified to capture all OPAT patients and manage them efficiently. We describe the development of EMR tools to facilitate OPAT management.
The infectious diseases (ID) physician and pharmacist identified multiple ways in which OPAT patient care could be improved by modifying the EMR. In 2016, a multidisciplinary team at URMC created software modifications in Epic to meet the needs of the OPAT program.
A shared system list and communication tools used by ID physicians, nurses, and pharmacists were created. As soon as an inpatient is identified as an OPAT discharge, an OPAT “Plan of care” note is created by an ID fellow, note is sent to the OPAT team members, (OPAT nurse, nurse practitioner and ID pharmacist) and the patient is added to the shared list. An order set was built to facilitate accurate electronic prescribing of antimicrobials, supplies for home infusions, and pertinent lab tests. The order set sends an automatic message to OPAT team members, a back-up method for identifying OPAT patients. A comprehensive patient report, the “OPAT monitoring” view, was designed to facilitate patient care. The view displays OPAT relevant data from multiple sections of the patient chart onto one screen (ID notes, lab results, medications, appointments, free text box, etc.) without entering each patient’s chart. These EMR modifications significantly reduced the time needed for weekly case reviews and facilitates more efficient management of 90-100 patients weekly.
Modifications made to the Epic EMR at our institution have improved patient safety and efficiency of the OPAT program. Fewer patients are missed, patient monitoring is enhanced, clinician time is saved, and ordering is more accurate. Physician satisfaction was improved by creating tools that were designed with workflow efficiency in mind. These modifications were independent of and predate the recommendations made in the Epic “OPAT setup and support guide”, and provide more enhancements for efficient patient management, and could easily be made by other Epic users.
C. Burgoyne, None