Interactive Web Page for Embedding Guidance In the Kaiser Permanente Electronic Health Record
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1 Interactive Web Page for Embedding Guidance In the Kaiser Permanente Electronic Health Record Wiley Chan, MD KP NW: Director, Guidelines & EBM Physician, Internal Medicine KP National: EBM Methodologist NHLBI: Co-Chair, Implementation Work Group Kaiser Permanente: Largest Non-Profit Health Care Program in the United States Permanente Medical Groups Kaiser Foundation Hospitals Kaiser Permanente Kaiser Foundation Health Plan Founded in regions in 9 states and District of Columbia 8.6 million members (as of 12/09) 15,129 physicians (as of 12/09) 164,098 employees (as of 12/09) KP Care Management Institute (CMI) KP National Guideline Program (NGP) Wiley Chan, MD 1
2 Overview Background: Guidelines must be implemented to impact health outcomes Guidance can be embedded in interactive web pages Linking interactive web pages to electronic health records (EHRs) has significant potential for impact Automated individual-level data transfer Meta-tagged links Place Orders from a web page into an EHR Learning Objectives After this session, attendees will be able to: Describe elements of a guideline web page that can address the needs of clinical users at the point of care List three levels of potential interactivity for guideline web pages Explore the pros and cons of interactive web pages for embedding guidance in their own systems Wiley Chan, MD 2
3 Web Portal: Dyslipidemia Navigation Bar Dyslipidemia Guideline Web Portal Structured to Support Clinical Decision-Making Web Portal: Dyslipidemia Clinical Risk Categories Treatment Thresholds Interventions Treatment Targets Pop-up Definitions Wiley Chan, MD 3
4 Web Portal: Dyslipidemia Logic-Encoded Web Pages, Meta-tagged links Combination allows individualized, actionable guidance, Wiley Chan, MD 4
5 User Enters Data Logic-Encoded Web Pages, Meta-tagged links Individualized Recommendations Returned Context with CAD Risk Placed in Gender/Age Group & Other Risk Factors Combination allows individualized, actionable guidance, 16 Data User Passed Enters Data from EHR Logic-Encoded to Web Server Web Pages, Meta-tagged links Individualized Recommendations Returned Context with CAD Risk Placed in Gender/Age Group & Combination allows individualized, actionable Other Risk guidance, Factors 16 Wiley Chan, MD 5
6 Data Passed from EHR Logic-Encoded to Web Server Web Pages, Meta-tagged links Individualized Recommendations Returned Meta-Tagged Links Return Orders in EHR Context with CAD Risk Placed in Gender/Age Group & Combination allows individualized, actionable Other Risk guidance, Factors 16 Combination of: Logic-Encoded Web Pages Automated Individual-Level Data Transfer Meta-Tagged Links Allows individualized, actionable guidance, Interactive Web Page Conclusions Interactive web pages can support the needs of clinical users at the point of care Present actionable guidance Provide entry point into larger guideline document Data transfer from an EHR to a web page can automate the presentation of guidance Functionality exists to turn interactive web pages into individualized, actionable guidance in an EHR Decision support logic can be encoded in the web pages, rather than built into EHR tools Wiley Chan, MD 6
7 Embedding Guidance in the Kaiser Permanente EHR Wiley Chan, MD 7
Embedding Guidance in the Kaiser Permanente EHR. Wiley Chan, MD Kaiser Permanente Care Management Institute Oakland, CA, USA
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