Implementing Training Videos for Student Clinicians to Improve Charting and Utilization of EHR Capabilities

Abstract

Introduction: In 2014, the student run Health Outreach Partnership of EVMS students (HOPES) clinic at Eastern Virginia Medical School (EVMS) implemented Practice Fusion, a free, web-based electronic health records system (EHR).  Since then, the goal has been to increase EHR utilization to improve clinic flow and to facilitate data gathering for clinic quality improvement purposes.  EHR training videos were developed to orient student clinicians to the EHR prior to their arrival in clinic.  This investigation serves to assess whether EHR utilization has increased since the implementation of the training videos. 

Methods:  A retrospective chart review was performed to evaluate completeness of 47 encounters following the implementation of EHR training videos compared to 40 encounters prior to implementation.

Results: 95% of encounters were signed by an attending pre-implementation of videos vs. 100% post.  70% of encounters had student clinician signatures before implementation while 72% were signed post implementation.  No screenings/preventive measures were documented before vs. 4.2% post implementation.  55% of encounters had smoking status before vs. 70% post-implementation.  30% of encounters had a social history before vs. 43% of post-implementation. 45% had past medical history before vs. 72% post-implementation.   68% had allergies recorded before while 70% had allergies recorded post-implementation.

Conclusion: Utilization of EHR capabilities by student clinicians has improved since the development of instructional videos.  Students are increasingly charting information in appropriate fields. However, further improvements can be made in all fields.  We found that the encounters that utilized the categorical fields of the EHR least tended to be specialty clinics (ophthalmology, dermatology).  Future changes include alerting specialty clinic coordinators to our findings to help facilitate EHR utilization with verbal reminders during clinic.