Electronic Health Record (EHR): How To Automate the Process

Tips for Information Technology (IT) Tools to Help with Decision Aid Delivery:

While integration into the EHR is not always necessary for decision aid delivery, it can be helpful to automate different aspects of the process.  For example, at Mass General Brigham, we have a Best Practice Advisory (BPA) in place to remind clinicians to order decision aids at the time of referral to an orthopedic surgeon. This toolkit will not address EHR integration issues specific to a decision aid or vendor; rather we focus on some tips and resources that may be applicable regardless of decision aid vendor:

  • Clinical decision support tools embedded in the EHR can enhance the care provided to patients at the right time that fits into a clinicians’ workflow. They support identification of appropriate use of tools during a decision window when patients are actively considering their treatment options.
  • There are different aspects of the workflow that can be supported with IT including reports to facilitate reliable, equitable patient identification, reminders and alerts to support decision aid ordering and use, and smartphrases to support thorough documentation.
  • Identify and include IT representative on the implementation team and/or identify someone from IT to serve as the liaison with the implementation team.
  • Plan ahead, as enhancements and changes to EHR can often take a long time and require multiple levels of approval.
  • Strong communication with leadership should emphasize the need for IT support and integration, and should focus on strategies to build and deploy IT solutions.
  • Once tools are in place, perform quality checks periodically to ensure IT tools and apps are working as intended (especially after EHR system upgrades).


Click here for “Decision Support Tools”. This PDF includes:

  1. Best Practice Advisory: Example of a BPA created in Epic where referring provider is asked if they want to send a decision aid to the patient prior to a specialist visit with a hip or knee arthroplasty surgeon.
  2. Smartphrase: Example of a smartphrase that can be used to support documentation of decision aid delivery and shared decision making conversation for hip osteoarthritis.
  3. Smartset: Example of how the decision aid is ordered automatically as part of lung cancer screening CT scan order to meet payer mandate.

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