A Multiple Sclerosis Flowsheet Registry Integrated with the Electronic Health Record to Provide Comprehensive Care and Local Research Opportunities
Multiple Sclerosis (MS) is an autoimmune disease which affects over 2 million people world-wide. It is complex to treat because the clinical course often differs among individuals. The entire clinical picture of the MS patient could be viewed easier by those caring for this population with the implementation of a MS Flowsheet Registry that is integrated with an electronic health record (EHR). Tracking long-term patient outcomes in the real-world clinical setting could help physicians and researchers understand this disease better and provide comprehensive care to MS patients.
Describe development of the Integrated (MS) Flowsheet Registry to provide a longitudinal, complete clinical picture of the MS patient for comprehensive care and local research opportunities.
The Illinois Neurological Institute (INI) MS Center in downstate Illinois identified a gap in their (EHR) with displaying the complete clinical picture of each MS patient in a quick format and for capturing information in a reportable way to expedite data collection for research purposes. The MS Flowsheet concept was envisioned in 2009 and has transformed from a paper version to an MS specific registry capable of interacting with the EHR. MS information such as disease modifying treatment history with reason for discontinuation, relapse information, lab and imaging results, and other assessments: EDSS, T25FW, 9HPT, cognitive assessments and PRO questionnaire information could be captured in reportable format in the registry instead of being embedded within narrative format progress notes in the EHR; which was the current state. OSF Saint Francis Medical Center, INI MS Center, and the University of Illinois College of Medicine at Peoria collaborated in the development of the MS Flowsheet Registry.
A research study is in progress on the cost benefit of integrating the MS Flowsheet Registry with the current EHR. The MS Flowsheet Registry was implemented as part of this research project. Predicted benefits of the registry included improved patient care, staff satisfaction, local research potential and a cost savings to the institution by decreasing hospital admissions due to relapses with the integration of the registry and current EHR.
We expect that the MS Flowsheet Registry will result in improved patient care and cost savings due to providing a longitudinal, complete clinical picture of the MS patient for comprehensive care and research. Additional studies are needed to evaluate the cost benefit of integrating a patient database within an EHR for the management of MS.