The transfusion of blood is a life-saving measure but is sometimes overused leading to worse outcomes for patients and excess costs for health systems. A team including IHQSE Faculty member Dr. Tyler Anstett engaged clinicians from different specialties to rethink the design of blood transfusion orders in the EHR at University of Colorado Hospital. This project, ultimately aimed at improving adherence with transfusion guidelines, was recently published in the January volume of Applied Clinical Informatics. We caught up with Dr. Brad Morse and Dr. Tyler Anstett to learn more about the motivation behind this project and what it could mean for future EHR design improvements.

Q1: Tell us about your approach to this project?

The transfusion of blood is a life-saving measure but is sometimes overused leading to worse outcomes for patients. We embarked on a project to modify the blood transfusion orders at our institution using a randomized trial. To optimize the new orders (and the trial) we sought input of clinicians working in our system. After doing simulated sessions, clinicians provided significant insights and improvements to what we initially designed.

Q2: Why is this work important?

As medicine marches forward through the digital age, human interaction with the electronic health record is becoming increasingly influential on the care provided to patients. It is critical that clinicians are involved in helping to design the digital tools that allow them to provide the best care. Unfortunately, clinicians are often left out of design decisions. This project highlights how engaging with clinicians in the design process can improve the ultimate product and is not too burdensome in terms of time or resources.

Q3: How do you think this will impact healthcare systems going forward?

We are introducing the concept of nudging clinicians to guideline concordant behaviors. In addition to the nudge, healthcare systems need to engage clinicians to (re)design the electronic tools used in everyday care of patients, and identify in workflows where nudges are appropriate. We believe it should be standard practice to involve clinicians and to rigorously study the effects that design choices, and in some cases nudges, have on care that is provided.


Read the full article here.