Pamela Tobias Discusses Handling Data in EHRs and the Future of Data in Clinical Practices

People are getting better at handling data in their electronic health records (EHRs), but there is a lot and there should be a way to categorize how the data should be used, said Pamela Tobias, MS, RHIA, CHDA, administrator of oncology services at Lehigh Valley Health Network.

Transcript

How can practices ensure they aren’t overwhelmed by the data in their EHR?

It’s a great question. The information in an EHR is overwhelming. I like to use the phrase “We eat the elephant one bite at a time.” And I tend to want to categorize projects that I’m working on. I like the 5 pillars of people, service, quality, cost, and growth, because I think it translates to all levels throughout the organization. When we want to focus on a quality project, what information can we seek out in our EHR that would allow us to automate and monitor some of those things?

It’s not a hard and fast rule to utilize that grouping. Maybe in your organization it’s better to use the triple aim of better health, health cost, better quality. Find whatever translates to you in terms of categorization and then pick 1 particular project where you think you can make an inroad and you can gain buy in and support on making that improvement.

Typically, if you pick a quality initiative you will also have cost inefficiencies that also come along with that as byproducts. Many of the initiatives that we identify fit into multiple categories—and that’s ok.

Are people getting better at handling all the data or are they having trouble catching up with more data and more measures to handle?

I think it’s a little bit of both. I think we’re getting better and more sophisticated in how to get information out of the system, designing—when we’re designing workflows on the front end—them with picking up those data points along the way that we know we’re going to want to study later on.

I think from a clinical perspective, the metadata that is in there, trying to be able to find everything, digest it, and then turn it around into a clinical decision is even harder. So, we really need to utilize things like the predictive analytics and get those embedded into our EHRs to provide that information to the physician or the nurse or whatever clinician is caring for the patient, rather than expecting them to do what we did in the old days, which is read a chart, digest everything, and make a decision from there. We have to be able to push more alerts and notifications that are unique to each patient to them, but finding that balance so that we’re not getting alert fatigue also.

What is the future of data in practices?

I think the future is not EHRs alone. I think as we’ve gotten more sophisticated at understanding what’s in our EHRs, we get hungry for more data. We want to link up to things like registries; we want to link up to payer databases; we want to link up to risk management and safety reporting systems to pull all that together for a bigger picture and greater understanding of what’s happening to our patients and how we can make things better in the world of healthcare.