Implementing Electronic Health Records: Before Go-Live and Beyond
My involvement in nutrition informatics started early in my career. I helped build, test and implement the nutrition component of a new medical record. I learned how data is entered, queried and reported on with the goal of enhancing patient safety.
Today, I'm still building on those lessons. Over the last two years, I have overseen the design, testing, implementation and troubleshooting of the nutrition component for a new electronic health records system at five area hospitals.
As our new EHR neared its "go-live date," my team tested the system rigorously by asking detailed questions to ascertain new workflows, defining dependencies and providing all staff with the tools and resources they needed, including training materials, user guides and web-recorded workflow reviews.
Though we thought we were prepared for everything, after going live, we realized some workflows as designed in the EHR testing environments were presenting challenges. These gaps in the workflow were identified early and we immediately began creating workarounds until more permanent solutions could be built.
Even now, after those initial challenges have been fixed, we're still making our product better. The nutrition experts at our affiliate hospitals convene regularly to identify issues with nutrition documentation and discuss possible solutions to achieve consensus and communication within the EHR. We provide feedback as a group to maximize efficiencies by standardizing processes and workflows to insure patient safety across the continuum of care.
I am encouraged by the progress we have made thus far. But, with systems continuously changing and upgrades occurring regularly, we cannot rest on our accomplishments. Instead, we need to continue to be at the forefront of change to advance nutrition content and its interoperability across organizations by asking questions, becoming involved and being patient and persistent.
Maria Santini, RD, LDN, CNSC, is a pediatric and outpatient nutrition services coordinator at Hasbro Children's Hospital in Providence, R.I.