The essence of healthcare records: embedded electronic health record system microblogging functionality for patient care narrative

Introduction

Electronic health record (EHR) systems capture information relating to patients across many specialties but can be complex, making rapid evaluation and communication of current important issues difficult.

Methods

As part of a children's hospital EHR implementation, we developed and implemented an embedded microblogging platform to allow users to provide a short summary of main issues or actions relating to the encounter, 'Essence' capturing the essence of the interaction. We reviewed usage by specialty and user type over a 1-year period.

Results

Ninety-one thousand, nine-hundred and fifty Essence entries were committed across 49 specialty areas during a 12-month period, April 2019 - April 2020. The specialties with greatest usage were cardiology, neurosurgery, intensive care, respiratory medicine and neurology, with 70% of entries by nursing staff. The median number of words used per entry was 17 words (range 1-120; mean 20.7), and microblogs were mainly used to describe actions, events or planned care. Manual content analysis of 200 representative entries demonstrated categories of importance (including clinical status, treatment plan, investigations, procedures and diagnoses) suggesting appropriate clinical utility.

Conclusion

Incorporation of an embedded EHR microblogging platform to capture key interactions with healthcare professionals represents a novel approach to coordinating care communication and is widely used across specialties, especially by nursing staff.