Guidelines and Protocols

I'm often asked about decision support capabilities in the BIDMC inpatient and outpatient EHR. I've previously written about our general principles of decision support and our priorities for implementing electronic guidelines and protocols.

I thought it would be interesting to show you the screens from our self-built Provider Entry System. I've included the protocol for Complex antibiotic ordering per protocol, our protocol for Heparin Dependent Antibodies, our Hydration Protocol to minimize risk of Iodinated Contrast Neprhropathy, Red Cell ordering, and TPN ordering.

I've also included an overview of our web-based ambulatory EHR, called webOMR. You'll see all the meaningful use features - vocabulary controlled problem lists, medication management (including medication reconciliation, e-prescribing, drug/drug interaction checking), clinical documentation, screening sheets which display all results and quality measures specific to treatment of a disease process, and ordering with complete decision support to ensure labs and radiology orders follow best practice guidelines.

The thematic definition of meaningful use is:

2011: To electronically capture in coded format, and to report health information, and to use that information to track key clinical conditions

2013: To guide and support care processes and care coordination

2015: To achieve and improve performance and support care processes and on key health system outcomes

Our inpatient and ambulatory systems are evolving constantly to meet these goals.