Evidence map›Paper›PMID 32395635›Full record

ArticleSleep science and practice2020

Quality improvement and practice-based research in sleep medicine using structured clinical documentation in the electronic medical record.

Demetrius M Maraganore, Thomas Freedom, Kelly Claire Simon, Lori E Lovitz, Camelia Musleh, Richard Munson, Nabeela Nasir, Smita Patel, Joya Paul, Mari Viola-Saltzman and 7 more

Abstract read
In one paragraph

Article in Sleep science and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Demetrius M MaraganoreDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Thomas FreedomDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Kelly Claire SimonDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Lori E LovitzDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Camelia MuslehDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Richard MunsonDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Nabeela NasirDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Smita PatelDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Joya PaulDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Mari Viola-SaltzmanDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Steven MeyersDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Richard ChesisHealth Information Technology, NorthShore University HealthSystem, 4901 Searle Parkway, Skokie, IL 60077, USA.
Laura HillmanHealth Information Technology, NorthShore University HealthSystem, 4901 Searle Parkway, Skokie, IL 60077, USA.
Samuel TidemanHealth Information Technology, NorthShore University HealthSystem, 4901 Searle Parkway, Skokie, IL 60077, USA.
Anna PhamDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Rosa Maria VazquezDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.
Roberta FrigerioDepartment of Neurology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA.

Funding

Quality Improvement and Practice Based Research in Neurology Using the EMRR01HS024057 · AHRQ · UNIVERSITY OF FLORIDA · PI MARAGANORE, DEMETRIUS MICHAEL · 2015 to 2019
$1.1M
AHRQ HHS R01 HS024057
6 · The paper itself

Abstract

backgroundWe developed and implemented a structured clinical documentation support (SCDS) toolkit within the electronic medical record, to optimize patient care, facilitate documentation, and capture data at office visits in a sleep medicine/neurology clinic for patient care and research collaboration internally and with other centers.

methodsTo build our SCDS toolkit, physicians met frequently to develop content, define the cohort, select outcome measures, and delineate factors known to modify disease progression. We assigned tasks to the care team and mapped data elements to the progress note. Programmer analysts built and tested the SCDS toolkit, which included several score tests. Auto scored and interpreted tests included the Generalized Anxiety Disorder 7-item, Center for Epidemiological Studies Depression Scale, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, and the International Restless Legs Syndrome Study Group Rating Scale. The SCDS toolkits also provided clinical decision support (untreated anxiety or depression) and prompted enrollment of patients in a DNA biobank.

resultsThe structured clinical documentation toolkit captures hundreds of fields of discrete data at each office visit. This data can be displayed in tables or graphical form. Best practice advisories within the toolkit alert physicians when a quality improvement opportunity exists. As of May 1, 2019, we have used the toolkit to evaluate 18,105 sleep patients at initial visit. We are also collecting longitudinal data on patients who return for annual visits using the standardized toolkits. We provide a description of our development process and screenshots of our toolkits.

conclusionsThe electronic medical record can be structured to standardize Sleep Medicine office visits, capture data, and support multicenter quality improvement and practice-based research initiatives for sleep patients at the point of care.

Indexed as

Best practicesClinical decision supportElectronic medical recordSleep disordersStructured clinical documentation support

Identifiers

PMID32395635
PMCPMC7213673

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.