title: Incorporating longitudinal pediatric patient-centered outcome measurement into the clinical workflow using a commercial electronic health record: a step toward increasing value for the patient.
abstract: Patient-centered outcomes measurement provides healthcare organizations with crucial information for increasing value for patients; however, organizations have struggled to obtain outcomes data from electronic health record (EHR) systems. This study describes how Texas Children's Hospital customized a commercial EHR system and assembled a cross-functional team to capture outcomes data using existing functionality. Prior to its installation and customization, no surgical subspecialties besides the congenital heart and transplant surgery groups conducted prospective, patient outcomes measurement, but by 2015, the outcomes of over 1300 unique patients with supracondylar fractures, cleft lip and/or palate, or voiding dysfunction had been tracked. Key factors for integrating outcomes measurement into the clinical workflow include ongoing communication between cross-functional teams composed of clinicians and technical professionals, an iterative design process, organizational commitment, and prioritizing measurement as early as possible during EHR optimization.
authors.affiliation: Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA kecarber@texaschildrens.org.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Carberry
authors.affiliation: Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Landman
authors.affiliation: Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Xie
authors.affiliation: Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Feeley
authors.affiliation: Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA.
authors.forename: John
authors.initials: J
authors.lastname: Henderson
authors.affiliation: Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA Texas Children's Hospital, Outcomes & Impact Service, Houston, TX, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Fraser
mesh_terms: D002648:Child; D057286:Electronic Health Records / Q000458:organization & administration*; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006801:Humans; D016347:Medical Records Systems, Computerized; D017063:Outcome Assessment, Health Care / Q000379:methods*; D018802:Patient-Centered Care; D013781:Texas; D057188:Workflow
keywords: Epic; electronic health records; outcomes; patient-centered outcomes measurement; value