Leveraging electronic medical record functionality to capture adenoma detection rate.

Area of Science:

• Gastroenterology
• Medical Informatics

Background:

• Adenoma detection rate (ADR) is a key quality metric for colonoscopies.
• Accurate and efficient ADR measurement is challenging but crucial for patient care.

Purpose of the Study:

• To develop an automated tool for measuring total ADR.
• To provide real-time feedback on ADR to endoscopists.
• To leverage existing electronic health record (EHR) functionalities.

Main Methods:

• Utilized the Epic EHR system and its existing tools.
• Developed a method for endoscopy staff to flag adenoma detection during colonoscopies.
• Integrated flagged data with colonoscopy records for automated ADR calculation and reporting within the EHR.

Main Results:

• The tool demonstrated high accuracy in a pilot study (97.4% sensitivity, 100% specificity, 98% accuracy).
• ADR measured by the tool closely matched manual chart review (53.1% vs. 53.8%, p=0.912).
• The tool successfully measured ADR for 145 pilot colonoscopies.

Conclusions:

• A tool using existing EHR functions was successfully developed and pilot tested.
• This tool can accurately and easily measure total ADR.
• The system provides valuable real-time feedback for endoscopists to enhance colonoscopy quality.