Leveraging the Electronic Health Record in Community Medicine and Preventative Care

The Electronic Health Record (EHR) has become an integral part of healthcare, and it has been thought to be a double-edged sword in its contribution to medicine. Often cited as a major contributing cause for physician burn-out, studies have shown that current implementations of EHR have yet to have as significant of an impact on patient safety and care as hoped.¹ Alternatively, studies have also shown the EHR can also serve as a tool in identifying patients that face barriers to care and recognizing health maintenance measures for patients.²

As Patient Navigators, our roles focus on increasing access to preventative care and helping address barriers in receiving said care. Through research, we realized a significant percentage of patients that were overdue for their health maintenance measure were so because they were unaware that they were. Moreover, due to time restraints and workload, physicians are often unable to focus on health maintenance measures when patients are able to come into the office. While routine annual visits would be the solution, several patients face barriers to transportation, and are only able to come in when unavoidable. In hopes of better addressing health maintenance measures, we asked ourselves “How can we leverage and improve the tools and system we already have in place to improve outreach for patients and maximize efforts to improve access to preventative care?”

Through coordination with a medical resident at the Lawrenceville Family Health Center, a solution was found through the EHR system. By referring to preventative screening reports already in place, we were able to identify patients who were overdue for their health maintenance measures and create a mass outreach message to inform patients of this status. The messages included brief education about why health maintenance was important and offered resources for patients to follow-up with their Primary Care Physician and/or schedule their routine screenings. The messages offered an avenue for patients to not only think about their health maintenance, but to discuss any barriers in addressing their health maintenance with Patient Navigators to better ensure continuity of care.

Currently, both UPMC St. Margaret Health Centers in Lawrenceville and New Kensington have had about 10% of patients that were previously not scheduled for a health maintenance screening get appointments set up for their screening since receiving a message. Although the rates may not be statistically significant, the process of using the EHR to identify patients overdue for their health maintenance measures highlighted how we can use tools already available to us in helping to improve access to preventative care. In improving access to care and addressing barriers, we hope to continue working towards making healthcare a more just and equitable system to all.

Sources:

1. Yanamadala, S., Morrison, D., Curtin, C., McDonald, K., & Hernandez-Boussard, T. (2016). Electronic Health Records and Quality of Care: An Observational Study Modeling Impact on Mortality, Readmissions, and Complications. Medicine, 95(19), e3332. https://doi.org/10.1097/MD.0000000000003332

2. Bates, D. W., Teich, J. M., Lee, J., Seger, D., Kuperman, G. J., Ma'Luf, N., Boyle, D., & Leape, L. (1999). The impact of computerized physician order entry on medication error prevention. Journal of the American Medical Informatics Association : JAMIA, 6(4), 313–321. https://doi.org/10.1136/jamia.1999.00660313