title: Follow-Up Survey on Functionality of Nutrition Documentation and Ordering Nutrition Therapy in Currently Available Electronic Health Record Systems.
abstract: BACKGROUND
  This is a follow-up survey to reassess the safety and efficacy of nutrition content in the available electronic health record (EHR) systems.
  
  
  METHODS
  Members of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), American Society for Nutrition, and the Academy for Nutrition and Dietetics were asked to participate in an online survey. The survey included questions from a 2012 EHR survey on the safety and efficacy in 5 nutrition content areas as well as questions from previous 2003 and 2011 A.S.P.E.N. parenteral nutrition (PN) surveys.
  
  
  RESULTS
  Percent of respondents using an EHR and using the EHR for less than 1 year increased between 2012 and 2014 (86%-94%, P < .05; 11%-16%, P < .05, respectively). However, there was no improvement in the safety and efficacy of the 5 nutrition content areas, with a significant decrease in 2 of these areas, ordering oral nutrition supplements and ordering PN. The top-rated EHR vendors had a higher average favorable response rate in regards to safety and efficacy in the nutrition content areas but even the top-rated EHR vendor had only a 60% average in favorable responses. Reported use of electronic PN ordering and a direct interface between the EHR and the automated compounding device (ACD) significantly increased from 2003 to 2011 to 2014 (29% to 33% to 63% and 16% to 19% to 28%, respectively, P < .05).
  
  
  CONCLUSIONS
  This is a call to action to nutrition support clinicians, societies, and organizations to proactively be involved in initiatives to educate clinicians and collaborate with EHR vendors to enhance the EHR systems to improve the safety and efficacy of providing nutrition therapy in hospitalized patients.
authors.affiliation: American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Clinical Nutrition Informatics Committee (CNIS), St Elizabeth Youngstown Hospital, Youngstown, Ohio, USA vince_vanek@mercy.com.
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Vanek
authors.affiliation: A.S.P.E.N. CNIS, Mississippi Baptist Medical Center, Jackson, Mississippi.
authors.forename: Phil
authors.initials: P
authors.lastname: Ayers
authors.affiliation: A.S.P.E.N. CNIS, Bellevue College, Bellevue, Washington.
authors.forename: Pamela
authors.initials: P
authors.lastname: Charney
authors.affiliation: A.S.P.E.N. CNIS, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kraft
authors.affiliation: A.S.P.E.N. CNIS, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Ronelle
authors.initials: R
authors.lastname: Mitchell
authors.affiliation: A.S.P.E.N. CNIS, Nationwide Children's Hospital, Columbus, Ohio, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Plogsted
authors.affiliation: A.S.P.E.N. CNIS, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Soden
authors.affiliation: A.S.P.E.N. CNIS, University of Missouri, Kansas City, Missouri, USA.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Van Way
authors.affiliation: A.S.P.E.N. CNIS, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Wessel
authors.affiliation: A.S.P.E.N. CNIS, Director of Informatics, Central Admixture Pharmacy Services, Puyallup, Washington, USA.
authors.forename: John
authors.initials: J
authors.lastname: Winter
authors.affiliation: Academy of Nutrition and Dietetics (Academy) Nutrition Informatics Committee (NIC), Clinical Systems Analyst, Center for Human Nutrition, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Sue
authors.initials: S
authors.lastname: Kent
authors.affiliation: Academy NIC, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Peggy
authors.initials: P
authors.lastname: Turner
authors.affiliation: Academy NIC, Hospital Sisters Health System Eastern Wisconsin Division, Green Bay, WI, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Bouche
authors.affiliation: Chair, Academy NIC Interoperability Standards Committee, Lexington Medical Center, West Columbia, South Carolina, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Quirk
authors.affiliation: American Society for Nutrition, Nutrition Education Committee, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Seidner
mesh_terms: D004282:Documentation / Q000592:standards; D057286:Electronic Health Records / Q000592:standards*; D005500:Follow-Up Studies; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D009752:Nutritional Status; D018529:Nutritional Support / Q000592:standards*
keywords: efficacy; electronic health records; electronic medical record; health information management; medical order entry systems; nutrition documentation; nutrition therapy; nutritional support; safety