Lessons Learned for Collaborative Clinical Content Development

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

 

Conflict of Interest

The authors declare that they have no conflicts of interest in the research.

• References

• 1 CMS.. Overview of Clinical Quality Measures Reporting in the Centers for Medicare & Medicaid Services (CMS) Final Rule on Meaningful Use. 2012
• 2 KLAS.. Meaningful Use Attestation 2012: Early Birds Take Flight. 2012: 74.
• 3 Marsolo K. Informatics and operations let’s get integrated. JAMIA. 2013; 20 (Suppl. 01) 122-124.
• 4 Institute of Medicine.. Health IT and Patient Safety: Building Safer Systems for Better Care. Washington, DC: 2012: 1-1.
• 5 Ford EW, Menachemi N, Huerta TR, Yu F. Hospital IT adoption strategies associated with implementation success: implications for achieving meaningful use. J Healthc Manag 2010; 55 (Suppl. 03) 175-188. discussion 188-189.
• 6 McAlearney AS. et al. Moving from good to great in ambulatory electronic health record implementation. J Healthc Qual 32 (05) 41-50. ((Author check citation –Year missing))
• 7 Sittig DF. et al. Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records. BMC Med Inform Decis Mak 2011; 11: 13.
• 8 Center for Disease Control and Prevention.. A Framework for Program Evaluation. Office of the Associate Director for Program (OADPG). 2012 Available from: http://www.cdc.gov/eval/framework/index.htm
• 9 ISO.. ISO Freely Available Standards. ISO Standards Maintenance Portal. 2013 [cited 2013 Feb 25]. Available from: http://standards.iso.org/ittf/PubliclyAvailableStandards/index.html
• 10 Kannry J. et al. The life cycle of Clinical Decision Support (CDS): CDS theory and practice from request to maintenance. AMIA Annual Symposium Proceedings 2012; 2012: 3-4.
• 11 QSR International.. NVivo 10 Qualitative Data Analysis Software.