EHR tool boosts geriatric assessments, trial finds



When a team of scientists integrated a tool into an electronic health record platform, it improved geriatric assessments and improved clinician knowledge about the evaluations, according to a report on the project published last week in Journal of the American Geriatrics Society

Geriatric assessments help doctors get a clear picture about a patient’s health. They include details on patients’ medical status as well as physical function, nutrition, mental health and social support. The five Ms of geriatric care, or the geriatric 5Ms — mind, mobility, multi-complexity, medications, and what matters most — offer a framework for geriatric assessments.

The team put in aspects of those factors, called SmartPhrases, into Epic EHR, a type of electronic health record platform.

The project rolled out in two Acute Care for Elders (ACE) unit rotations at the University of Pennsylvania and Yale University, and an outpatient geriatrics rotation at Cornell University. The rotations lasted two weeks and the outpatient rotation lasted one week as part of a four-week geriatrics block. Faculty and geriatric fellows led students in training on the new system. Trainees received a pre-survey at the start of the rotation and a survey after the rotation completed, as well as a follow-up survey three months after the rotation was finished or at the end of the academic year. Fellows and faculty also completed surveys at the end of the school year.

Across all three sites, 137 trainees used the new program and nearly 74% completed the surveys. The students said they had more knowledge of geriatric assessments and comfort performing them as a result of the program. Survey responses said the tool helped facilitate the assessment with prompts for questions. 

“Respondents felt the SmartPhrase helped with geriatrics learning, patient-centered care and recognizing the 5Ms,” the authors wrote.

The authors noted a few must-have elements to successfully enact the SmartPhrase tool. What they learned: Integrating the tool into the curriculum helped students understand geriatric assessments and learn about how to use the actual system. Also, SmartPhrase should be tailored to meet the needs of each institution. And the workflow may be impacted by the SmartPhrase itself, which is a factor when modifying the tool. Finally, faculty buy-in was key to guide students in using the tool and better understanding geriatric assessments, the team suggested.

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