Infographics, EHR help support better care of open sores

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Clinicians have demonstrated that the use of wound-care tracking within an electronic health records system supports the healing process.

The initiative, at the University of Pittsburgh Medical Center, paired software to graph wound dimensions over time with the organization's EHR, enabling clinicians to more closely monitor the healing process.

The research studied the impact of improving treatment of open sores caused by chronic venous insufficiency. Medical teams formally collaborated on the project and used a visual “infographic” to track how steadily wounds were—or were not—closing.

The ability to better measure changes within the EHR helped physicians step in at the right time with other tools to help patient conditions improve. Use of the EHR tracking and more timely treatment improved the healing rate of patients by more than 46 percent, compared with the pre-study average.

Before the study began in 2014, the institution had no coordinated or comprehensive care plan for patients with CVI. The average rate of healing for long-term wounds was around 53 percent. The research looked at improving how patient progress was monitored, says Ellen Dillavou, MD, the vascular surgeon who led the project along with Julie Bitner, a physician assistant.

Dillavou and Bitner implemented a new wound care tracking process in the EHR, enabling clinicians to use software to graph wound dimensions over time; previously, clinicians just typed dimensions of wounds into their narrated notes. That enables nurses and doctors looking at patients’ charts to assess the progress of open wounds.

While the effects of medical records on healing are seldom studied, this research found a direct correlation, the researchers noted. The average rate of healing was 79 percent at study’s end.

“After the initial time investment to get the software set up, it was no more time intensive than standard visit documentation and yielded better longitudinal results,” says Ulka Sachdev, MD, a vascular surgeon who was one of the researchers on the project.

In some cases, a surgical procedure can improve vein flow back to the heart or remove dysfunctional veins. Sachdev and fellow researchers are developing new research that may one day point the way to prevent chronic venous insufficiency. Until then, she said, “anything that speeds up healing can improve the quality of life for these patients and give them hope.”

The study appears in a new article in the Journal for Vascular Surgery—Venous and Lymphatic Disorders.

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