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Kidney Week

Abstract: FR-PO257

A Streamlined Electronic Decision Support for the Management of Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Aron, Abraham W., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Lecker, Stewart H., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Pollak, Martin R., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Poyan-Mehr, Ali, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Background

Caring for patients with CKD requires the management of multiple medical conditions and is highly complex, data-driven and difficult to consolidate. Increased time spent on electronic health records (EHRs) is frequently perceived as an impediment to patient-centered care and has been shown to increase physician burnout. We have created a streamlined, electronic dashboard and decision support tool to consolidate CKD management, enhance efficiency and improve the clinician’s work experience.

Methods

A total of 6 core content areas, 14 decision support notifications and over 90 data elements were systematically arranged into a single dashboard within our institution’s EHR. This was further enriched by links to professional literature and patient handouts. To assess the impact of this decision support tool, we conducted a survey amongst providers at our single tertiary care center.

Results

We received over 300 responses. 12% were Nephrology attendings/fellows, 24% were primary care physicians and 64% were medical residents. Amongst responders, 60% used the tool in their clinical practice. It is used primarily in the outpatient setting (69%), and most frequently for the assessment of CKD etiology/stage (48%), management of mineral and bone disorders (29%) and anemia management (22%). The streamlined CKD dashboard and decision support tool was considered by 56% of respondents as helpful in preventing physician burnout.

Conclusion

While EHRs are frequently cited as a major source of physician burnout, an enhanced user interface can lead to an improved work experience. The widespread voluntary adoption of our CKD dashboard and electronic decision support suggests opportunities for EHRs to impact CKD management, enhance efficiency, and improve the clinician’s work experience. Our data further suggests benefits of augmenting decision support and automated guidance while caring for patients with CKD.

Figure 1. User deomgraphics of the decision support tool.