Electronic charting of transfusion medicine consults: implementation, challenges and opportunities

• Authors: Jeannette Guarner, Emory University; Charles Hill, Emory University; John Roback, Emory University; Mohammad K Mohammad, Geisinger Commonwealth School of Medicine; Melanie S Wooten, Emory University; Cheryl Maier, Emory University; Anne M Winkler, Reagent R&D and Medical Affairs; Harold Sullivan, Emory University
• Journal Title: VOX SANGUINIS
• Volume: Volume 115, Number 5
• Publisher: WILEY | 2020-03-20, Pages 443-450
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1111/vox.12913
• Subjects: Health Sciences, Pathology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Hematology; documentation; e-charting; e-consults; record; transfusion medicine; TRANSITION

Abstract

Background: The Joint Commission lists improving staff communication (handoffs) as part of several National Safety Goals. In this study, we developed an electronic web-based charting system for clinical pathology handoffs, which primarily consist of transfusion medicine calls, and evaluated the advantages over a paper-based handwritten call log. Materials and Methods: A secure online web browser application using Research Electronic Data Capture (REDCap) was designed to document on-call pathology resident consults. A year after implementation, an online survey was administered to our pathology residents in order to evaluate and compare the usability of the electronic application (e-consults) to the previous handwritten call log, which was a notebook where trainees hand wrote different components of the consult. Results: The REDCap web-based application includes discrete fields for patients’ information, requesting physician contact, type of consult, action items for follow-up and faculty responses, as well as other information. These components have eventually progressed to be an online consult call catalog. With approximately 1079 consults per year, transfusion medicine-related calls account for ~90% of the encounters, while clinical chemistry, microbiology and immunology calls constitute the remainder. The overall response rate of the survey was 96% (29 of 30 participants). Of the 16 respondents who experienced both call log systems, 100% responded that REDCap was an improvement over the handwritten call log (P < 0·0001). Conclusion: E-consult documentation entered into a web-based application was a user-friendly, secure clinical information access and effective handoff system as compared to a paper-based handwritten call log.