JMIR Publications

ABSTRACT

Background:

While EHR brings various benefits to healthcare, EHR systems are often criticized as cumbersome to use, failing to fulfill the promise of improved healthcare delivery with little more than a means of meeting regulatory and billing requirements. Besides, EHR systems have been recognized as one of the contributing factors for physician burnout.

Objective:

Specialty-specific Electronic Health Records (EHR) systems have been suggested as an alternative approach that can potentially address challenges associated with general-purpose EHRs. We introduce Epilepsy Tracking and optimized Management engine (EpiToMe), an exemplar bespoke EHR system for epilepsy care. EpiToMe uses agile, physician-centered development to optimize clinical workflow and patient care documentation. We also report the initial feedback of EpiToMe on its utility on physician burnout.

Methods:

Using collaborative, asynchronous data capturing interfaces anchored to a domain ontology, EpiToMe distributes reporting workload among technicians, clinical fellows, and attending physicians. Results of documentation are transmitted to the parent EHR to meet patient care requirements with a push of a button. An HL7 messaging engine exchanges information between EpiToMe and EHR to optimize clinical workflow tasks without redundant data entry. EpiToMe also provides live, interactive patient tracking interfaces to ease the burden of care management.

Results:

Since February 2019, 12,422 electroencephalogram (EEG) reports, 929 Epilepsy Monitoring Unit (EMU) daily reports, and 1,125 EMU phase reports have been completed in EpiToMe for 5,393 unique patients. A ten-question survey was completed by 11 (among 16 invited) senior clinical attendings. Consensus was found that EpiToMe eased the burden of care documentation for patient management, a contributing factor to physician burnout.

Conclusions:

EpiToMe offers an exemplar bespoke EHR system combining physician-centered design with the latest advances in information technology. The bespoke approach has the potential to ease the burden of care management in epilepsy.