1. Implementation of an Electronic Health Record (EHR) OSCE at Two Institutions (PE02) Frances E. Biagioli, MD 1 ; James Tysinger, PhD 2 ; K. Ashok Kumar, MD 2 ; Ryan Palmer, EdD 1 1 Oregon Health and Science University 2 UT Health Science Center at San Antonio February 6, 2015

2. Disclosures The speakers have no conflict of interest posed by the content of this presentation. Federal grant funding relates to the content of this presentation. –National Cancer Institute (1R25CA158571-01A1). Integrating Patient Centered EHR and HIT Curriculum into BSS Medical Education. PI: Frances Biagioli, MD IRB approval and consent for use of videos/images is on file

3. Objectives Discuss an innovative curriculum for training students to maintain patient rapport and promote patient safety while using an electronic health record (EHR). Discuss strategies for evaluating and giving students feedback on the safe and effective use of EHRs. List strategies, recommendations, and ways to overcome challenges while implementing an EHR training curriculum with its related OSCE.

4. The OHSU EHR Curriculum Purpose: Address students’ knowledge gaps about effectively integrating an EHR into a patient encounter Contents  Session on EHRs to pre-clinical students  EHR-OSCE for FM Clerkship students  EHR-Chart Biopsy for a Complex Patient for FM Clerkship students

5. EHR OSCE

6. Checklist’s Assessment Categories 1.Verbal and Non-Verbal Communication Skills Example: Introduced self to the patient 2.EHR-Related Communication skills Example: Established rapport with the patient before turning to the computer 3.EHR Data-Gathering Skills Example: Reviewed and updated patient’s medication list Derived from Morrow JB, et al. First year medical students can demonstrate EHR-specific communications skills. Fam Med. Jan 2009, pp 28-33

7. UTHSCSA Implementation Challenges and Strategies Hardware/Software/Infrastructure  Computer in the room (e.g., laptop, tablet, COW)  EPIC environment (simulated EHR)  Power, Wi-Fi IT support/staff training –Password, results entry, appointment –Faculty/staff EPIC password/training –Unexpected issues due to EPIC updates Petition SOM: IT support for EHR education

8. UTHSCSA Checklist Additions Verified the patient’s identity by asking for full name and DOB on the EHR Secured the patient’s medical record by clicking the “Secure” button. Altered wording on several items (e.g., “During a majority of the visit was able to maintain eye contact with the patient”)

9. Sample Item from the EHR OSCE Checklist% Correct (N) Established rapport BEFORE turning to the computer66.2 (47) Verified the patient’s allergy59.2 (42) Reviewed EHR medication list with the patient38.0 (27) Reviewed EHR past medical history and problem list with the patient 21.1 (15) Reviewed the patient’s social history including sexual history 52.1 (37) OHSU Student Performance on the EHR OSCE

10. Questions for Participants How do your students learn EHR skills? What EHR curricular successes have you had? For more information contact: Frances Biagioli, MD (bee-uh-joe-lee), Professor OHSU Family Medicine, biagioli@ohsu.edubiagioli@ohsu.edu

11. Please evaluate this session at: stfm.org/sessionevaluation PE02 Implementation of an Electronic Health Record (EHR) OSCE at Two Institutions Frances E. Biagioli, MD, et al.