| Description |
Solid organ transplant has become an established and cost-effective therapy for persons with end-stage renal, hepatic, or pancreatic disease. Long-term survival depends on the patient, the surgical procedure, the donated organ, the management of immunosuppressive therapy, and the detection and management of complications following surgery. Clinical information concerning transplant patients is voluminous and difficult to manage when using paper records. A system analysis was performed to assess the information system needs of the liver, kidney, and pancreas transplant program at LDS Hospital in Salt Lake City, Utah. After evaluating workflow, data collection forms, decision support needs, and functional requirements, we designed and implemented an extendable information system to support the process of care following liver transplantation. Tools for collecting and entering information into the electronic health record (EHR) were developed, including an operative note and data entry forms for external laboratory results and transplant-related information. A new information model, consistent with national interoperability standards, was developed for storing donor-related information in a transplant patient's record. Once coded, external laboratory information was available in the EHR, clinicians could view both external and Intermountain Health Care (IHC) laboratory results in chronological order. This view was particularly usefiil when the paper flowchart was not available. The laboratory and transplant-related information triggered decision support alerts that were designed to notify nurses when liver transplant patients had new, abnormal, or overdue laboratory results. The alerts improved the quality of laboratory information used for outpatient care. Compared with the traditional process of reporting laboratory results with faxes and printouts, the alerts resulted in more timely, complete, and efficient reporting of laboratory results. The time for responding to laboratory results was cut by one-third from a median of 33 to 9 hours after specimen collection. Results were reported in realtime"" and clinicians could act on information the same-day results arrived. The components developed for this project addressed only part of the needs of the liver, kidney, and pancreas transplant program; however, the system design can be enhanced in the fixture to meet other program needs."" |
