Summary
Background: Site-specific content configuration of vendor-based Electronic Health Records (EHRs)
is a vital step in the development of standardized and interoperable content that
can be used for clinical decision-support, reporting, care coordination, and information
exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project
at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content
with adequate breadth and depth to meet the needs of all types of acute care clinicians
at two academic medical centers. The Knowledge Management (KM) team at PHS led the
informatics and knowledge management effort for the project.
Objectives: We aimed to evaluate the role, governance, and project management processes and resources
for the KM team’s effort as part of the standardized clinical content creation.
Methods: We employed the Center for Disease Control’s six step Program Evaluation Framework
to guide our evaluation steps. We administered a forty-four question, open-ended,
semi-structured voluntary survey to gather focused, credible evidence from members
of the KM team. Qualitative open-coding was performed to identify themes for lessons
learned and concluding recommendations.
Results: Six surveys were completed. Qualitative data analysis informed five lessons learned
and thirty specific recommendations associated with the lessons learned. The five
lessons learned are: 1) Assess and meet knowledge needs and set expectations at the
start of the project; 2) Define an accountable decision-making process; 3) Increase
team meeting moderation skills; 4) Ensure adequate resources and competency training
with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams
and supportive, consultative service based teams.
Conclusions: Knowledge management requirements for the development of standardized clinical content
within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing
and meeting informatics knowledge needs, 2) setting expectations and standardizing
the process for decision-making, and 3) ensuring the availability of adequate resources
and competency training.
Citation: Collins SA, Bavuso K, Zuccotti G, Rocha RA. Lessons learned for collaborative clinical
content development Appl Clin Inf 2013; 4: 304–316
http://dx.doi.org/10.4338/ACI-2013-02-CR-0014
Keywords
Knowledge management - content development - standardization - governance - program
evaluation
