Using Social Knowledge Networking (SKN) Technology to Enable Meaningful Use of EHR Technology

利用社会知识网络 (SKN) 技术实现 EHR 技术的有意义使用

• 批准号: 9356490
• 负责人: Pavani Rangachari
• 金额: $ 16.73万
• 依托单位: AUGUSTA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2018-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9356490
• 关键词: Using; Social; Knowledge; Networking; SKN

PROJECT SUMMARY Owing to the heightened risk of medication errors during patient care transitions, the “meaningful use” of the EHR Medication Reconciliation functionality, has potential to significantly improve quality & patient safety, and reduce healthcare costs. Despite the federal policy impetus towards EHR Medication Reconciliation however, hospital adherence has lagged for one chief reason—low physician engagement—which in part, stems from lack of professional consensus about which physician is responsible for managing a patient's medication list and the value of medication reconciliation as a clinical tool for improving quality of care. GR Health has recently launched certified EHR technology throughout its health system. Like many hospitals, a key challenge faced by GR Health is that physicians who did not place the original order for a patient's medication, are resistant to completing EHR Medication Reconciliation at discharge, leading to frustrated patients with incomplete medication lists and higher-than-expected medication error rates. This pilot/feasibility project seeks to implement a Social Knowledge Networking (SKN) system to enable GR Health to progress from “limited use” of EHR Medication Reconciliation technology, to “meaningful use.” Step 1 (Development Phase) will be to enhance an existing SKN system (Microsoft-Yammer's) capability to promote EHR medication reconciliation; and integrate the tool into the EHR workflow at GR Health. Step 2 (Pilot Phase) will be to conduct a pilot/feasibility test of the SKN system in the outpatient & inpatient settings at GR Health. Specific aims are to examine: 1) user-engagement in the SKN system through SKN user surveys & SKN usage analytics; and 2) preliminary associations between “SKN use” and “EHR meaningful use.” The rationale is that an SKN system would bring together a diverse group of practitioners (physicians, nurses, pharmacists, IT specialists, and administrators), to facilitate the exchange of tacit knowledge (practice- based knowledge) on the problem of interest. Tacit knowledge exchange in turn, is expected to increase practitioners' engagement in solving the problem, promote learning, and enable practice change (i.e., EHR meaningful use). The pilot study would include 6 SKN Moderators (senior administrators & MD champions) and 60 SKN Users (practitioners) from the outpatient & inpatient medicine service. The hypothesis is that proactive, periodic “top-down” efforts of SKN Moderators to promote EHR Medication Reconciliation would synergize with “bottom-up” exchange of tacit knowledge by SKN Users, to enable engagement, learning, and meaningful use. The project is highly responsive to the FOA, since it seeks to test a strategy for health IT use, implementation, and design, which in turn is aligned with three of AHRQ's five health IT research priorities. If the hypothesis holds, federal EHR vendors could be encouraged to incorporate SKN features into EHR systems. The study will utilize a range of quantitative, qualitative, and social network analytic techniques to examine SKN user engagement, SKN usability, SKN usage analytics, and EHR meaningful use.

项目摘要 由于患者护理过渡期间药物错误的风险增加，因此“有意义地使用” EHR药物对帐功能，有可能显着提高质量和患者安全性，并且 降低医疗保健成本。尽管联邦政策推动了EHR药物和解的动力，但 医院的依从性滞后是出于一个主要原因 - 较低的身体参与，部分原因是 缺乏专业共识，即哪种物理学负责管理患者的药物清单 以及药物对帐作为改善护理质量的临床工具的价值。 GR Health最近在整个卫生系统中推出了经过认证的EHR技术。像许多人一样 医院是GR Health面临的主要挑战 患者的药物有抵抗力在出院时完成EHR药物对帐，导致 沮丧的药物清单不完整的患者和高于预期的药物错误率。 该试点/可行性项目旨在实施社会知识网络（SKN）系统，以实现 GR健康从“有限使用” EHR药物对帐技术到“有意义的使用”发展。 步骤1（开发阶段）将是增强现有的SKN系统（Microsoft-Yammer）的功能 促进EHR药物和解；并将该工具集成到GR Health的EHR工作流程中。步骤2 （试点阶段）将在门诊和住院设置中对SKN系统进行试验/可行性测试 GR健康。具体目的是检查：1）通过SKN用户调查＆ SKN使用分析； 2）“ SKN使用”和“ EHR有意义的使用”之间的初步关联。 理由是，SKN系统将召集一个潜水员的从业者（医师，， 护士，药剂师，IT专家和管理人员），促进默认知识的交换（实践 - 基于知识的知识）。隐性知识交换又有望增加 实践者参与解决问题，促进学习和使实践改变（即EHR） 有意义的用途）。试点研究将包括6个SKN主持人（高级管理人员和MD冠军）和 来自门诊和住院医学服务的60个SKN用户（从业人员）。假设是积极主动的， SKN主持人的定期“自上而下”努力促进EHR药物对帐将与 SKN用户对隐性知识的“自下而上”交换，以实现参与，学习和有意义的使用。 该项目对FOA的反应很高，因为它试图测试它使用的健康策略， 实施和设计又与AHRQ五个健康IT研究重点中的三个保持一致。如果 假设的存在，可以鼓励联邦EHR供应商将SKN功能纳入EHR 系统。该研究将利用一系列定量，定性和社交网络分析技术来 检查SKN用户参与度，SKN可用性，SKN使用分析和EHR有意义的用途。