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Electronic Health Record Serious Illness Conversation Dashboards: An Implementation Case Series
Yasmina Hachem1, Joshua Lakin2, Winifred Teuteberg3
1Beth Israel Lahey Health Mount Auburn Hospital (Y.H.), Cambridge, Massachusetts, USA.
Journal of Pain and Symptom Management
|November 7, 2024
Summary
Serious illness conversation (SIC) dashboards improve quality but face challenges. Clinician adoption of documentation templates and receptivity to data impact their reliability and use in healthcare.
Area of Science:
- Health Informatics
- Quality Improvement
- Palliative Care
Background:
- Dashboards visualize quality indicators in health systems to enhance clinical performance.
- Structured documentation templates for serious illness conversations (SICs) in electronic health records (EHRs) enable SIC dashboard development for quality improvement.
- Limited information exists on the successes and challenges of SIC dashboards.
Purpose of the Study:
- To explore the successes and challenges encountered by health systems in implementing serious illness conversation (SIC) dashboards.
- To identify themes related to the use and impact of SIC dashboards in quality improvement initiatives.
Main Methods:
- An implementation case series design was employed.
- Semi-structured interviews and surveys were conducted with nine palliative care leaders across eight health systems.
- Qualitative analysis of interview data and case information was performed to identify key themes.
Main Results:
- Dashboards primarily focus on process metrics, enhancing data access for monitoring clinician training and quality improvement efforts.
- Palliative care leaders utilized dashboard data to drive practice change, though clinician reactions to data were mixed.
- Dashboard implementation required significant financial and technical resources, and challenges included data reliability issues stemming from inconsistent use of structured documentation templates.
- Integrating patient-centered outcome measures into dashboards presented challenges and tensions.
Conclusions:
- SIC dashboards are valuable for identifying care gaps and promoting clinician practice change.
- Challenges in clinician adoption of structured documentation templates and mixed receptivity to data feedback can hinder dashboard reliability and effectiveness.
- Further research is needed to optimize SIC dashboard implementation and address clinician engagement.
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