CC BY 4.0 · ACI open 2022; 06(01): e50-e56
DOI: 10.1055/s-0042-1749196
Original Article

Lessons Learned from Creating Alert Governance during an Electronic Health Record Transition

Michelle Stoffel
1   Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, United States
2   UW Medicine Information Technology Services, Seattle, Washington, United States
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
,
Sundeep Desai
2   UW Medicine Information Technology Services, Seattle, Washington, United States
,
Megan Laine
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
,
Michael G. Leu
2   UW Medicine Information Technology Services, Seattle, Washington, United States
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
4   Department of Pediatrics, University of Washington, Seattle, Washington, United States
5   Division of Hospital Medicine, Seattle Children's Hospital, Seattle, Washington, United States
,
Zachary C. Liao
2   UW Medicine Information Technology Services, Seattle, Washington, United States
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
6   Department of Medicine, University of Washington, Seattle, Washington, United States
,
Jeehoon Jang
2   UW Medicine Information Technology Services, Seattle, Washington, United States
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
6   Department of Medicine, University of Washington, Seattle, Washington, United States
,
Angad P. Singh
2   UW Medicine Information Technology Services, Seattle, Washington, United States
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
7   Department of Family Medicine, University of Washington, Seattle, Washington, United States
,
Nikita Pozdeyev
8   Division of Bioinformatics and Personalized Medicine, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States
,
Paul R. Sutton
2   UW Medicine Information Technology Services, Seattle, Washington, United States
3   Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
6   Department of Medicine, University of Washington, Seattle, Washington, United States
,
Adam Wright
9   Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Andrew A. White
2   UW Medicine Information Technology Services, Seattle, Washington, United States
6   Department of Medicine, University of Washington, Seattle, Washington, United States
› Author Affiliations
Funding None.

Abstract

Background Our multihospital transition to a single electronic health record (EHR) provided an opportunity to transform alert governance. Our case provides insights into the unique challenges and opportunities of creating governance during a transition to meet both implementation and future alert management needs.

ObjectivesThis case report describes the efforts of UW Medicine Information Technology Services to advance alert governance during EHR transition and highlights the opportunities to improve care quality and provider experience within a changing environment.

Methods We used a multidisciplinary approach and external evidence to define governance for provider-facing interruptive alerts. We established the context for our governance efforts with a systemic environmental scan. We used literature review and expert consultation to determine alert design and performance best practices, sought to design postimplementation evaluation tools, and engaged clinical stakeholders to help with decision-making.

Results We created alert design and implementation tools and an alert approval process, eliminating 21 unnecessary alerts prior to implementation. We developed prototype evaluation metrics and enlisted clinical owners for postimplementation optimization of 221 alerts.

Conclusion We leveraged the fluid environment of our EHR implementation to rapidly build a provider-led governance infrastructure to meet immediate transitional needs and to facilitate future alert maintenance and improvement.

Author Contributions

All authors contributed to the work in accordance with the criteria established by the International Committee of Medical Journal Editors.


Protection of Human and Animal Subjects

Human subjects were not included in this project.




Publication History

Received: 09 April 2021

Accepted: 11 February 2022

Article published online:
29 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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