HealthMay 14, 2024

Evidence-based information in the EHR supports teamwork and an improved clinician experience

Integrating evidence-based information into the EHR is key to managing the daunting amount of information healthcare professionals face today.

Clinicians navigate an overwhelming amount of information across care settings. When the electronic health record (EHR) properly leverages an evidence-based approach to streamline this information, it can support improved outcomes, more efficient cross-team coordination, and a healthier clinician experience.

To achieve effective integration, healthcare leaders should explore the reasons integration with the EHR is necessary, the potential of evidence-based information, and the challenge of maintaining team coordination through implementation.

Evidence-based information is transformative in healthcare settings

Evidence-based medicine (EBM) is highly useful in addressing myriad challenges in healthcare delivery. In Jordan, it has been used to confront provider bias among family planning providers and their prejudices against certain contraception methods. But uptake has often been challenging, even among physicians trained in the systematic method of EBM. A study by BMC Medical Education on applying EBM to improve quality and attractiveness of work concluded that organizational support is important to facilitating the uptake of evidence-based medical information in practice.

Integrating resources into the EHR is an often-untapped opportunity for leaders to provide this level of facilitation. This point is especially evident when looking at the five main steps for applying EBM in clinical practice:

  1. Define a clinically relevant question.
  2. Search for the best evidence.
  3. Critically appraise the evidence.
  4. Apply the evidence.
  5. Evaluate the performance of EBM.

The EHR can and should be instrumental in each of these steps. EBM acts as a framework for applying evidence-based information to a patient’s conditions while the healthcare professional's clinical judgment is used to tailor treatment to patient care needs. This combination creates a helpful roadmap for clinicians, including nurses, allied health professionals, doctors, and interprofessional teams in using EBM to improve outcomes based on the highest quality evidence available.

Integrating evidence-based information into electronic health records is an untapped opportunity

The ubiquity of the EHR in patient interactions is why it can be so powerful in operationalizing evidence-based information and streamlining decision-making processes. Since healthcare professionals have immediate access to the EHR, it connects evidence-based medicine to the point of care, impacting both the provider and patient experience.

Elizabeth Tomaszewski, DNP, RN, CRNP, CNE, CCRN, ACNP-BC, ACNPC, Clinical Content Manager for Lippincott Solutions, Wolters Kluwer Health stresses the importance of the EHR in bringing evidence-based information into clinician-patient interactions.

“Clinicians have access to necessary information right at the moment a patient might have a question about their disease or condition. If a patient didn’t understand a hurried physician, a nurse can take the time to tell them more about their disease simply by accessing the EHR, and without delay. This demonstrates that the nurse is invested in patient care and that the team overall has an understanding of patient needs—it proves they’re invested in delivering on that desire, even with everything going on in healthcare right now.”

Evidence-based information in the EHR can address moral injury

Currently, many clinicians are pushing back on the concept of burnout in healthcare, saying they aren’t necessarily overworked and instead are demoralized by the fatigue of the industry and system. Moral injury in a healthcare context is largely tied to clinicians feeling as if they can’t provide high-quality care for their patients.

These clinicians are at higher risk when they feel forced to perform actions like prescribing medications a patient can’t afford or discharge unhoused people back onto the street.  A 2022 survey by the Physicians Foundation found that six in 10 physicians felt they had little to no ability or time to effectively address their patients’ social determinants of health. The EHR can serve as a conduit for the evidence-based information clinicians need to support improved patient outcomes and have socially sensitive conversations.

The EHR should facilitate the use of evidence-based information to support teamwork

The American Hospital Association (AHA) stresses the importance of communication and teamwork in providing quality healthcare and maintaining patient safety, “When all clinical and nonclinical staff collaborate effectively, health care teams can improve patient outcomes, prevent medical errors, improve efficiency, and increase patient satisfaction.”

However, as teams moved away from the physical patient chart and to the EHR, a point of connection and interaction between healthcare professionals degraded. Michael Shabot, MD, FACS, FCCM, FACMI, explains that “since nurses worked with the chart, while doctors had to write in it and pharmacists often used the same file for drug verification, the chart brought healthcare professionals together and supported teamwork. But today, the EHR allows the pharmacist to be off in one set of cubicles and the nurses to be on the floor and the doctors to be in their offices—nobody's talking to each other. This results in a dearth of that kind of practical collaboration in optimizing patient care that happened naturally when the patient and the chart existed together.”

The EHR should enable collaborative use of evidence-based information

But the EHR can facilitate collaboration between disciplines and specialties, especially when evidence-based information drives alignment. It can help coordinate patient care on an informed basis and support joint clinical decision-making based on shared data.

Overcoming its asynchronous nature requires adaptation at the organizational, behavioral, and technical levels. The future of high-quality care will depend on an EHR that’s enabled with evidence-based decision support technology that integrates with team workflows to support a better clinician experience and facilitate continuous improvement in patient outcomes.

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