Impact and User Satisfaction of a Clinical Information Portal Embedded in an Electronic Medical...

Impact and User Satisfaction of a Clinical

Information Portal Embedded in an

Electronic Medical Record

Nancy Tannery, MLSHealth Sciences Library System

University of Pittsburgh

The SettingHealth Sciences Library System (HSLS) Large academic library serving University of

Pittsburgh’s six health sciences schools, and the University of Pittsburgh Medical Center (UPMC)

UPMC 20 tertiary, specialty, and community hospitals, with

4,200+ licensed beds 400 outpatient sites and doctors’ offices 5,000 affiliated physicians / 55,000 employees 1,400 residents

HSLS receives support from UPMC to provide system-wide access to licensed online resources.

Health Sciences Library SystemUniversity of Pittsburgh

UPMC eRecord

Design and implementation began >10 years agoApplications rolled out in multiple phases at various hospitals200 clinical applications from 120+ vendors, including EPIC & CernerInteroperatibility Project (joint development w/ commercial company)


The Vision

Take advantage of library’s wide array of e-books, and point-of-care information toolsMinimize dependence on any one resourceMinimize redundancyUse Vivisimo technologyImplement in the electronic medical recordUtilize evolutionary approach, move forward in small steps


First version: Clinical-e

Epstein BA, Tannery NH, Wessel CB, Yarger F, LaDue J, Fiorillo AB. Development of a clinical information tool for the electronic medical record: a case study. J Med Libr Assoc July 2010JMLA Preprints http://www.mlanet.org/members/jmla/index.html


Version 2: Clinical Focus

http://www.hsls.pitt.edu/guides/clinical/


SourcesACP PierBMJ Clinical EvidenceCochrane Database of Systematic

ReviewsFirst Consult Medical ConditionsCurrent Medical Diagnosis & TreatmentCurrent Treatment in…. (Lange

Textbooks)MicromedexMedCalc 3000



Clinical Focus -EMRPowerChart

EPIC


Use

November December January February March April0

200

400

600

800

1000

1200

1400

# queries


Survey

Validated survey* 18 questions using a 5-point rating scaleUser satisfaction, information quality, system quality, individual impact DemographicsSurvey available from January – April 2010IRB approval as an exempt study

*Delic D, Lenz HJ. Benchmarking user perceived impact for web portal success evaluation. JIOS. 2008: 32(1):1-14.


Survey promotion

Library and UPMC newslettersGrand Rounds presentationsEmailsNote on residents’ internal web siteNotice on the library’s web siteIncentive to participate


Survey Results

Other

Student

Nurse

Resident/Fellow

Physician

0 5 10 15 20 25 30 35

# respondents

92 respondents


Information Quality

10.6

5.9

3.6

31.7

14.1

9.5

9.4

42.3

57.6

63.1

65.9

15.3

22.35

23.8

24.7

Strongly Disagree Disagree Undecided Agree Strongly Agree

% responses

relevant

up-to-date-cur-rent

complete

exclusive


System Quality

2.33.4

2.3

1.1

4.5

2.2

6.7

14.9

15.9

13.5

14.6

10.1

15.7

56.3

60.2

59.5

53.9

52.8

56.2

22.9

21.6

25.8

26.9

34.8

21.3

Strongly Disagree Disagree UndecidedAgree Strongly Agree

organized

easy-to-read

easy to navigate

hyperlinks valid

pages load quickly

search function helpful

% responses


User Satisfaction

1.1

1.1

7.8

3.3

11.1

14.4

57.8

60

22.2

21.1


meets expectations

satisfied

% responses


Individual Impact

9.3

2.2

2.2

29.1

4.4

4.4

4.4

33.1

17.8

28.9

21.1

22

61.1

47.8

52.2

6.5

16.7

16.7

20

Strongly Disagree Disagree UndecidedAgree Strongly Agree

better informed

better decisions

competent

risk

% responses


Individual Impact

4.4

4.4

15.6

18.9

53.3

58.9

26.7

17.8


visit regularly

recommend

% responses


FindingsUse of Clinical Focus 4X higher than the previous version Clinical-eSurvey results suggest User satisfaction was very high. Clinical Focus easy to read and

navigate Better informed and made better

decisions Use Clinical Focus regularly Recommend to their colleaguesHealth Sciences Library

SystemUniversity of Pittsburgh

Limitations

Small sample size Self selected samplePossible response bias


Next Steps

Continue monitoring and marketingWork with interoperability group to pre-populate the search box with patient-specific information from the eRecordFormal evaluation to determine reliability and validity


Co-authors

Barbara Epstein, HSLS Director Charles Wessel, Head of Hospital

Services Fran Yarger, Assistant Director for

Computer Services John LaDue, Knowledge Integration

Librarian Mary Lou Klem, Reference Librarian


Date post:	18-Dec-2015
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