MedStar Health Human Factors Center to Work with Virginia Tech on NIH R01 Grant Award to Better Leverage Unstructured Patient Safety Report Data to Advance Care

Virginia Tech has announced that its team will collaborate with the MedStar Health National Center for Human Factors in Healthcare on a newly-awarded, multi-year Research Project Grant (R01) from the National Institutes of Health (NIH) to advance care by developing novel statistical methods to analyze unstructured text in patient safety event reports and to identify temporal trends and patterns in the data.

Raj Ratwani, PhD, director of the MedStar Health Human Factors Center and associate professor at Georgetown University School of Medicine, and Allan Fong, research scientist with the Center, will serve as principal investigators (PI), along with project lead and PI Srijan Sengupta, assistant professor of statistics in the College of Science and a faculty member at the Discovery Analytics Center at Virginia Tech.

The Center is contributing its expertise in machine learning, natural language processing, patient safety, reporting databases that can be used to identify safety trends and patterns, and translating resources like those established through this grant into healthcare environments to improve patient safety.

“This research is critical to identifying patterns in the reported data and turning data into knowledge that the healthcare provider can then use to assess the safety of their technologies and processes and develop actions and interventions to prevent patients from being harmed by recognized hazards,” said Ratwani.

R01 awards from the U.S. Department of Health and Human Services are among the most prestigious grant mechanisms. The Center is proud that this marks its fifth active multi-year R01 award, among its other large, high-impact research efforts that are advancing health care. In addition to this award, the Center’s top leaders are the PIs on three Agency for Healthcare Research and Quality (AHRQ)-funded R01s that focus on improving the safety of electronic medication administration records, usability and safety guidelines for health information technology, and technology to support emergency department communication, as well as another NIH National Library of Medicine-funded R01 on developing effective clinical decision support.

Read more about the Center’s latest R01 award in the Virginia Tech press release here, and on the NIH’s website here. Read the overview of all Center R01 awards and other high-impact research grants here.

AHRQ’s New Health IT Research Year in Review Report Features MedStar Health Human Factors Research and Outcomes

This October, the Agency for Healthcare Research and Quality (AHRQ) released its Health Information Technology Research 2018 Year in Review, including overviews and outcomes of AHRQ-funded work awarded to MedStar Health Research Institute (MHRI) and led by the MedStar Health National Center for Human Factors in Healthcare (Center). The Center is part of the MedStar Institute for Innovation and regularly partners with MHRI. Click here to read more and download the AHRQ report

AHRQ investments detailed throughout the report aim to improve the quality and safety of health care via health information technology (health IT). The report has been released for years, typically annually and dating back to 2008. It supports AHRQ stakeholders, including patients, clinicians, researchers, and policymakers, with learning about the research, goals, and progress; emerging technologies; and how to access related information and products to support knowledge transfer and replicate successes. 

Six Active Center Research Projects Featured

The report recognizes the following MHRI-awarded, Center-led AHRQ research that was active in 2018 (Note: Page numbers refer to the online PDF pages): 

  • Developing Evidence-Based, User-Centered Design and Implementation Guidelines to Improve Health Information Technology Usability (page 53). This R01 grant is among AHRQ’s health services research projects and is led by principal investigator Raj Ratwani, PhD.
  • Improving Patient Safety and Clinician Cognitive Support Through eMAR [Electronic Medication Administration Records] Redesign (page 53). This R01 grant is also among AHRQ’s health services research projects and is led by principal investigator Raj Ratwani, PhD.
  • Context is Critical: Understanding When and Why Electronic Health Record Related Safety Hazards Happen (page 61). This R21 grant is among AHRQ’s exploratory and developmental grants to improve healthcare quality through health IT and is led by principal investigator Aaron Zachary Hettinger, MD.
  • Cognitive Engineering for Complex Decisionmaking & Problem Solving in Acute Care (page 70). This R01 grant advances AHRQ’s work to understand clinical information needs and healthcare decision-making processes in the context of health IT and is led by principal investigator Aaron Zachary Hettinger, MD.
  • Quantifying Efficiencies Gained through Shareable Clinical Decision Support Resources (page 78). This AHRQ contract is led by principal investigators Kristen Miller, DrPH, and Aaron Zachary Hettinger, MD.
  • Advancing the Collection and Use of Patient-Reported Outcomes through Health Information Technology (page 79). This AHRQ contract is led by principal investigators Deliya Wesley and Raj Ratwani, PhD.

Feature Stories Sharing More Information 

Additionally, two MedStar-led efforts were highlighted among stories about AHRQ’s emerging and innovative newly-funded 2018 research, which strives to ensure health IT is designed and implemented in ways that improve quality and safety without placing excessive burden patients, physicians, and other users.

  • Leveraging Clinical Decision Support (CDS) to Advance Research Evidence into Clinical Practice (page 24): This work compares CDS tools developed in isolation with those developed using resources available on CDS Connect, an AHRQ-funded project to translate evidence-based care into clinical practice with interoperable CDS. It includes four healthcare systems and two EHR vendors to allow for analytic comparisons within and across sites to identify efficiencies when using shareable and interoperable CDS resources. 
  • Supporting AHRQ Step Up App Challenge to Encourage Use of Patient-Reported Outcomes (PRO) to Improve Patient Care (page 25): The challenge encouraged participants to create apps that advanced the collection of standardized PRO data in ambulatory care settings both within and across different providers. MedStar Health is modifying and pilot testing an application that incorporated the draft technical specifications to enable broader PRO data sharing for clinical and research purposes, as well as the winning app from the Step Up App Challenge.  

In one of three patient safety Health IT research spotlights, the report also details how AHRQ health IT safety investigator and Center director Raj Ratwani, PhD, and team are using health IT research and advocacy to make a real difference in improving patient safety.

  • Improving Electronic Health Record (EHR) Design and Usability to Increase Patient Safety, Especially for Children (pages 31-32). Leveraging a novel natural language processing algorithm, the team analyzed medication-related patient safety report data from three health institutions and identified and categorized those related to EHR issues and possible patient harm in children. They found pervasive problems through this work and ultimately aim to establish clear guidelines for both EHR vendors and healthcare providers that will lead to usability improvements and avoid harm to patients.
  • Representing AHRQ Health IT-Funded Research in Health Affairs Patient Safety Issue and Event (page 45). The November 2018 issue of Health Affairs, as well as a related event, included a comprehensive look at the best and latest patient safety research, including the aforementioned AHRQ research by Dr. Ratwani. These efforts raised awareness about emerging issues in patient safety and explored ways to close gaps in research, policy, and implementation to reduce patient harm. 

Explore the full AHRQ report for more information about this research and related resources, as well as other AHRQ-funded initiatives taking place beyond MedStar Health to advance health IT research, quality, and safety. Follow the Center on Twitter, Facebook, and its main website for regular updates about its AHRQ-funded work and other important initiatives.

Becker’s Hospital Review Lists MedStar Institute for Innovation Among Innovation Centers to Know

The MedStar Institute for Innovation (MI2) is included in Becker’s Hospital Review’s 2019 list of more than 40 hospitals and health systems with great innovation programs.

Becker’s Healthcare recognized the organizations on this list for their commitment to staying on the forefront of change in health care.

The recognition also includes a brief profile of MI2’s work that helped earn this recognition as an innovation center to know in 2019. The article highlights MI2’s efforts to co-host challenges featuring innovative ideas from within MedStar Health, and work within the MedStar Health National Center for Human Factors in Healthcare, MedStar Health Simulation Training & Education Lab, MedStar Telehealth Innovation Center, and MedStar Pharmacogenomics Initiative—all among other important contributions from talented MI2 colleagues.

Read Becker’s Hospital Review’s full list here and its profile on MI2 here.

Congratulations to all organizations featured for sharing a commitment to catalyzing innovation that advances health.

MedStar Health’s Raj Ratwani Receives American Psychological Association Award for Early Career Achievement

Raj Ratwani, PhD, director of the MedStar Health National Center for Human Factors in Healthcare and associate professor of the Georgetown University School of Medicine, recently received the American Psychological Association’s (APA) Earl Alluisi Award for Early Career Achievement. The award recognizes outstanding research and other achievements made by psychologists within 10 years of receiving their PhD.

Dr. Ratwani’s contributions to the field include advancing electronic health record (EHR) usability research and policy recommendations, laying the foundation for solutions to prevent or mitigate interruptions and task resumption challenges in health care, and leading the Center’s growth and visibility on regional, national, and international levels. The Center is part of the MedStar Institute for Innovation and works in partnership with MedStar Health Research Institute and others throughout MedStar Health.

Read more about Dr. Ratwani and his award here.

MedStar Health National Center for Human Factors in Healthcare Experts to Analyze the Nation’s Largest Patient Safety Database to Advance Care

Raj Ratwani, PhD, Director, MedStar Health National Center for Human Factors in Healthcare

MedStar Health Research Institute has been awarded a contract from Pennsylvania's Patient Safety Authority for a multi-year project analyzing the largest patient safety database in the country.

The work will be led by principal investigator, Raj Ratwani, PhD, Director of the MedStar Health National Center for Human Factors in Healthcare, a partner of MHRI that is embedded in the MedStar Institute for Innovation in Washington, D.C.

The collaborative team will use innovative machine learning algorithms to quickly identify areas where improvements can be applied to shape the future of safe and effective patient care. Pennsylvania is the only state in the U.S. that requires healthcare facilities to report events that could potentially cause harm to patients, as well as events that have been shown to cause harm. The MedStar Health Human Factors Center is uniquely positioned for this work given its experience at the intersection of research, innovation, and action to inform patient care.

Learn more in the related press release.

Educators at MedStar SiTEL Receive CIRCLE Grants For New Medical Education At Georgetown University Medical Center

Alex Walker, PhD, Senior Director, Learning Research and Design, MedStar SiTEL
John Yosaitis, MD, Medical Director, MedStar SiTEL

Two educators at MedStar Simulation Training & Education Lab (SiTEL) have received faculty grants from Georgetown University Medical Center (GUMC) for the educational initiatives they designed for students.

Both John Yosaitis, MD, MedStar SiTEL’s medical director, and Alex Walker, PhD, senior director of learning research and design, were among this year’s recipients of GUMC’s CIRCLE Grant. The grant is awarded to faculty pursuing innovative educational initiatives for the benefit of medical students and the institution.

Yosaitis collaborated with students and an interdisciplinary group of faculty to make diverse, peer-to-peer and self-directed experiential learning opportunities accessible to students at Georgetown University School of Medicine (GUSOM) around the clock. In addition to his role at MedStar SiTEL, Yosaitis is director of the Integrated Learning Center and assistant professor at Georgetown University Medical Center.

In a separate effort, Walker and other collaborators will use the award to develop a pre-matriculation workshop for students that explores strategies for learning in medical school, as well as how to become self-regulated, confident learners. Walker is an assistant professor of emergency medicine at Georgetown University Medical Center.

Read more.

First Emergency Department Innovation Challenge Successfully Hosted Across MedStar Health

Challenge Steering Committee members Ken Canonge (left), Kathryn Burroughs (center), and Kevin Maloy (right) leading the event.
Challenge Steering Committee members Ken Canonge (left), Kathryn Burroughs (center), and Kevin Maloy (right) leading the event.

Why—and how—did a diverse group of MedStar Health Emergency Department (ED) associates (innovatively) share more than 50 ideas that could improve the ED experience across our system—regardless of their job in the department?

This March, the 2019 MedStar Health Emergency Department Innovation Challenge invited MedStar associates whose main job responsibilities focus on the ED—including nurses, physicians, advanced practice clinicians, techs, security, social workers, and any others—to submit ideas individually or in teams of up to five people that could change their ED shift. MedStar Emergency Physicians co-sponsored the Challenge with MedStar Institute for Innovation, MedStar Risk Management, and MedStar Nursing, offering two great prizes to both winning teams: MedStar exploring the ideas and tickets to a sporting event. Entries were submitted online and summarized the problem the idea addressed; the solution and its implementation; the value proposition of the innovation; metrics for measuring success; why the idea (like any idea!) might not work; and the people entering.

Selecting the Winning Ideas

Challenge judge Jonathan Davis announcing the winners.
Challenge judge Jonathan Davis announcing the winners.

Both peers and judges ultimately helped identify the two winners via a multi-part process. First, the Challenge Steering Committee identified 25 semifinalists from the 52 submissions for inclusion in a peer voting process. Next, from April 3 through April 10, ED colleagues could each cast up to 10 votes for ideas with the greatest potential via an online survey, logging nearly 1,500 votes overall to identify the eight finalists detailed below, along with event pictures.

On April 25, seven crowd-sourced finalists each presented a 4-minute pitch, either in-person or via recorded video, followed by a 4-minute Q&A, to a panel of judges and other attendees at the MedStar Innovation and Design (MIND) Lab located off the main lobby of MedStar’s corporate headquarters in Columbia, MD. The judges who selected the winners after a closed-door discussion included MedStar leaders Jonathan Davis, Susie O’Mara, Chris Richter, Larry Smith, and Mark Smith.

The winners included:

  • It’s 2019, and we read a MRN on the phone to admit a patient? A hospitalist communication system for admissions
    Carolyn Phillips and Michael Yacovelli
    MedStar Washington Hospital Center and MedStar Georgetown University Hospital emergency medicine resident and attending physician team
  • Less PercoceT and more PT: The MedStar Health Urgent Physical Therapy Program
    Munish Goyal, John Brickley, Lindsay Batson, and Liz Delasobera
    MedStar National Rehabilitation Hospital, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, and MedStar PromptCare physician and physical therapist team

The Challenge Steering Committee stressed that they may also further explore other finalist ideas, in addition to summarizing the themes from all submissions for leadership review.

Igniting Innovation Energy at MedStar

Challenge finalist Elizabeth Marx (left) connecting with Challenge judge Mark Smith (right), among others networking.
Challenge finalist Elizabeth Marx (left) connecting with Challenge judge Mark Smith (right), among others networking.

The timing of the Challenge also marked the one-year anniversary of the MIND Lab, an innovative space for all MedStar associates and visitors to see, think, and work differently. The MIND Lab is a venue for creativity, collaboration, and curiosity—all qualities that made the first MedStar Health Emergency Department Innovation Challenge a success.

Stay tuned for information about future Innovation Challenge opportunities and outcomes, and congratulations to all participants.

CHALLENGE FINALISTS
Note: Named in the order pictured, from left to right, if applicable. Those who are not pictured have an asterisk next to their name.

WINNERS

Less PercoceT and more PT : The MedStar Health Urgent Physical Therapy Program
Munish Goyal, John Brickley, Lindsay Batson, and Liz Delasobera*
MedStar National Rehabilitation Hospital, MedStar Washington Hospital Center, MedStar Georgetown University Hospital, and MedStar PromptCare physician and physical therapist team
It's 2019, and we read a MRN on the phone to admit a patient? A hospitalist communication system for admissions
Carolyn Phillips and Michael Yacovelli
MedStar Washington Hospital Center and MedStar Georgetown University Hospital emergency medicine resident and attending physician team

OTHER FINALISTS

Whose vein is it anyway? Piloting existing technology to stop sticking patients repeatedly for blood
Debbie Heckler and Elizabeth Marx
MedStar Union Memorial Hospital nurse team
Modernizing the waiting room: Improving the waiting experience with text messages and videos
Jennifer Thompson*, De Anndra Charles, Manpreet Saran*, and Carren Heinser*
MedStar Washington Hospital Center physician, nurse, and patient advocacy team
Does PPID really have to be this hard? Putting a monitor with a scanner and printer in every ED room
Rachel Thornton*, Beth Luther*, and Victoria Mestre*
MedStar Washington Hospital Center nurse team
Is this an airport or an ED? Patient kiosk check-in for the ED waiting room
Rahul Bhat and Tamara Katy
MedStar Georgetown University Hospital and MedStar Washington Hospital Center physician team
Your advanced directive is ... somewhere in the computer: Making MOLSTs easier to find in the EHR
Kelly Schutz, Sarah Marrone, and Kevin Scruggs*
MedStar Good Samaritan Hospital
Excuse me but ----- : Decreasing interruptions with EHR integrated non-critical communication technology
Rahul Bhat
MedStar Georgetown University Hospital and MedStar Washington Hospital Center physician

MedStar Human Factors Center Launches EHRSeeWhatWeMean.org and Encourages Action

On Feb. 4, 2019, the MedStar Health National Center for Human Factors in Healthcare launched EHRSeeWhatWeMean.org and a related campaign, presenting compelling evidence for the need to address the known risks to patient safety and clinician burnout that stem from poor electronic health record (EHR) usability—and calling for action.

The website, which was launched in collaboration with the American Medical Association, makes videos from the clinician’s point of view available for the first time to demonstrate the risks and challenges caused by poor EHR usability, which is the extent to which the technology can be used efficiently, effectively, and satisfactorily. The site also specifically calls out what multiple stakeholders—policymakers, healthcare providers, EHR vendors, and patients—can do.

The theme of the website and campaign is ‘Everybody Has Responsibilities’ to stress the need for increased collaboration. As a shared opportunity for action, stakeholders can sign the MedStar Human Factors Center’s letter to elected leaders of the United States Senate and House committees that can prioritize EHR usability and safety in their oversight of new policies being put in place by the Department of Health and Human Services. Click here to sign the letter to Congress by Feb. 28, 2019, the month that marks the 10-year anniversary of the federal act that successfully promoted the widespread adoption of EHRs.

For a deep dive into the research and thought leadership informing that letter, read the Journal of the American Medical Association Viewpoint, “A Decade of Health Information Technology Usability Challenges and the Path Forward,” which was written by Raj Ratwani, PhD, who leads MedStar’s Human Factors Center, and two co-authors, all of whom serve as top EHR usability and safety experts.

Learn more about the videos and campaign in MedStar’s press release: “Experts Call for Safety Improvements as Widespread EHR Adoption Reaches 10 Year Milestone.”

Media Contact

Marianne Worley
[email protected]
410-772-6661

Journal of the American Medical Association: Improving Electronic Health Record Usability and Safety Requires Transparency

Ratwani-Health-Affairs

On Nov. 29, 2018, the Journal of the American Medical Association published a viewpoint article titled, “Improving Electronic Health Record Usability and Safety Requires Transparency,” by authors from MedStar Health’s National Center for Human Factors in Healthcare, American Medical Association, and Brigham and Women’s Hospital.

The opinion piece examines how gag clauses in EHR vendor and healthcare provider contracts block providers from openly addressing EHR usability and safety issues, representing “a market failure.” Despite the 21st Century Cures Act inviting action to help prevent this in 2016, the Office of the National Coordinator (ONC) of Health Information Technology has yet to define what constitutes blocking EHR usability and safety information. The article discusses three main criteria the ONC should consider in doing so and why it’s critical to act on this now.

Learn more about the background and policy recommendations tied to this issue in MedStar’s related press release: “3 Policy Changes That Could Make Electronic Health Record Systems Safer and Easier to Use.”

Photo Credit: Health Affairs.

Media Contact

Marianne Worley 
[email protected]
410-772-6661

Health Affairs: Identifying Electronic Health Record Usability And Safety Challenges In Pediatric Settings

Ratwani-Health-Affairs-2

On Nov. 5, 2018, the health policy journal Health Affairs published an article by MedStar Health’s National Center for Human Factors in Healthcare and its collaborators titled, “Identifying Electronic Health Record Usability and Safety Challenges in Pediatric Settings.”

It reported that electronic health records (EHRs) may present a significant risk to the health and safety of children. Of 9,000 analyzed pediatric reports more than one third described a medication error that was related to EHR usability. The findings emerged from the analysis of pediatric patient safety event reports that were likely to be related to EHRs and medication, gathered from three healthcare systems.

Learn more about the findings, related stakeholders, and calls to action in MedStar’s press release: “Additional Safety Measures Recommended After Study Finds EHR Usability Issues Pose Risk to Children.”

Raj Ratwani, PhD, director of MedStar’s Human Factors Center and a lead researcher and author, also discussed the study further on Nov. 6 as part of a Health Affairs briefing on its full “Patient Safety” issue, where numerous article authors commented on the best and latest research on this topic. Click here to read more and watch the recorded webcast.

Photo credit: Health Affairs.

Media Contact

Marianne Worley
[email protected]
410-772-6661