PHILADELPHIA – Each year, advances make medical devices safer and propel the development of ever-more targeted drugs and precise surgeries. Digital health technology is also emerging as a force to revolutionize patient care. Penn Medicine is driving the trend with an ambitious new plan to transform electronic health records (EHRs)—turning them into more streamlined, interactive, smarter tools that ease the work of clinicians, expedite care, and drive the best possible patient outcomes.
“We recognize that EHRs are no longer just part of how clinical care is documented, but they are central to how clinical care is delivered,” said J. Larry Jameson, MD, PhD, executive vice president of the University of Pennsylvania for the Health System and dean of Penn’s Perelman School of Medicine. “Increasingly, health information technology plays a foundational role in each domain of our work: patient care, educating the next generation of physicians and scientists, and biomedical research. Electronic health records innovations are key to advancing our impact in each of those missions.”
Many clinicians today view EHRs as static, digital remakes of paper charts that can increase work load, contribute to burnout and create barriers to delivering high-quality patient care. To address those issues head-on, Penn Medicine leadership will seek input and support from within its walls to make EHRs more clinician-friendly as a key requirement for better patient care.
“We’re approaching this endeavor as if we were building a new clinical facility, laboratory, or training program: with a focus on the clinicians’ and patients’ needs,” said Ralph W. Muller, CEO of the University of Pennsylvania Health System. “Everything that shapes patient care should be designed to support the best possible outcomes. Electronic health records are a natural focus because they connect to everything we do.”
With current EHRs, much of the data entry falls on the doctors and nurses, which can cut into the time they spend caring for patients and leave them feeling like data clerks. Physicians must also sift through significant amounts of data to find the most useful and relevant pieces of information, rather than receiving pertinent information about their patients in a more actionable, tailored manner.
Penn Medicine experts have already begun to map new approaches to EHR design. In a recent Perspective piece published in the New England Journal of Medicine, David A. Asch, MD, MBA, executive director of the Penn Medicine Center for Health Care Innovation, and his colleagues suggested that a restructuring of the EHRs should allow doctors to “subscribe” to their patients’ clinical information to receive real-time updates when an action is required, similar to social media feeds and notifications.
The Penn Medicine Nudge Unit has developed approaches to ensure that patients are referred for lifesaving cardiac rehabilitation following heart attacks, that statins are prescribed to those who need their cholesterol managed, and advanced CT scan imaging is provided to all patients who need it, but not to those who don’t. Each of these care improvements was facilitated through a redesign of Penn’s electronic record system to serve physicians’ needs as they care for patients.
“Ultimately, we need to move past the idea that the EHR is just an administrative tool, and see it as a clinical tool – like a scalpel, or a medication, or an X-ray machine,” Asch said. “We judge these tools by the degree to which they facilitate good patient care, and we should be judging the EHR against the very same standard.”
Penn Medicine also launched a new innovation tournament to identify the earliest targets for EHR transformation. Teams from across the health system including IT experts, data scientists, and clinical educators will work alongside clinicians and staff to help develop, test, and refine improvements. The health system will also be introducing “sprints” in which clinical groups can work together with the different teams to streamline and improve EHR interactions and engagement with email and other digital media.
“Every day, we’re supporting, learning and running tests to investigate new ideas in the clinic, lab, and the classroom. Our best ideas come from within our walls,” Muller said. “With this initiative, the future of electronic medical records will be written by those working each day at Penn Medicine.”
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.
The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report’s survey of research-oriented medical schools. The School is consistently among the nation’s top recipients of funding from the National Institutes of Health, with $405 million awarded in the 2017 fiscal year.
The University of Pennsylvania Health System’s patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center — which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report — Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; Penn Wissahickon Hospice; and Pennsylvania Hospital – the nation’s first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine, and Princeton House Behavioral Health, a leading provider of highly skilled and compassionate behavioral healthcare.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2017, Penn Medicine provided $500 million to benefit our community.