Abstract TP79: Epic Smartblocks: Faster Note And Better Look

Abstract

Introduction: Electronic health records (EHRs) were introduced into healthcare in order to minimize errors and increase efficiency. Unfortunately, the use of EHRs have also resulted in note bloat (“notes that contain multiple pages of nonessential information, often leaving key aspects buried or lost”). SmartBlocks (figure 1) in Epic EHR can be utilized in the stroke note template in order to reduce the amount of time it takes to complete each note, reduce note bloat, and automate data capture. Method: We first introduced SmartBlocks in the ischemic stroke note template at University of Mississippi Medical Center (UMMC) in 2019 in order to capture patient timeline and NIHSS. However, majority of the note still comprised of SmartLists which were buried in paragraphs and were amenable to non-standardized modifications. Major changes to the note were then made in October 2021 with the introduction of SmartBlocks in the assessment and plan sections. This allowed for a click-through model with guideline-based choices, output to be more objective with bullet points and grouping, and auto-population of selected smart elements in the REDCap database. Pre-implementation surveys were given to 12 UMMC neurology residents (PGY II-IV) between August-September 2021. Post-implementation surveys of the same residents were carried out between May-June 2022. Each survey contained fifteen questions with Likert scale choices. Results: Of the 12 residents surveyed, 84% responded with excessive time to extract relevant information from the pre-implementation note (vs 17% post-implementation). Note completion time was decreased for 58% of the residents after SmartBlock implementation (vs 25% pre-implementation). Overall satisfaction with the look of the note increased from 25% to 66%. Overall satisfaction with the information contained in the note increased from 8% to 75%. Conclusion: Implementation of SmartBlocks in stroke notes can reduce note bloat and time to note completion.