Symptom Tracking in Primary Care: Designing and Testing an EHR-Embedded Safety-Net System

Area of Science:

• Primary Care Medicine
• Health Informatics
• Patient Safety

Background:

• Systematic symptom tracking is crucial for preventing missed diagnoses in primary care.
• Existing symptom tracking systems are limited in primary care settings.
• Worrisome symptoms require reliable monitoring to ensure timely intervention.

Purpose of the Study:

• To design and test a novel electronic health record (EHR)-embedded symptom tracking system.
• To improve the follow-up rates and timeliness of worrisome symptoms in primary care.
• To evaluate the feasibility and effectiveness of an EHR-integrated symptom monitoring tool.

Main Methods:

• Historical chart review to establish baseline symptom follow-up rates.
• Iterative design and testing of prototypes by systems engineers and clinicians.
• Development of an EHR-embedded tool for systematic symptom order placement and tracking.

Main Results:

• The EHR-embedded symptom tracking system significantly improved follow-up rates (84.8% vs. 60.5%).
• The system markedly increased the timeliness of symptom follow-up (mean 20 days vs. 101.6 days).
• The tool was found to be feasible and accepted by primary care clinicians.

Conclusions:

• A pilot EHR-embedded symptom tracking system demonstrated feasibility and improved reliability.
• The system enhanced the timeliness and completion rates of worrisome symptom follow-up.
• Wider adoption requires workflow redesign for efficiency and sustainability in routine primary care.