In our recent webinar, Putting the problem list into practice: Exploring tools that create meaning and drive usability, hosted in collaboration with MUSE (Medical Users Software Exchange), we had the privilege of sitting down with Priscilla Frase, MD, CMIO at Ozarks Healthcare, and IMO Health’s Jim Thompson, MD, to discuss the nature of the problem list, including how it’s utilized and its transformative impact on patient care within the organization.
Click below to watch the entire webinar.
Pressed for time? Continue scrolling for a few clips and excerpts from this session.
What’s in a medical problem list:
Dr. Thompson, a physician informaticist at IMO Health, discusses the importance of proper categorization, stating, “Over time, a problem list in any electronic health record becomes an attic of everything anybody ever said about a patient. It’s complete, but impossible to navigate. By categorizing problem lists, a meaningful clinical picture can emerge, making it easier to manage and improve patient care. Proper categorization reduces cognitive load for clinicians and helps create better care plans.”
How Ozarks Healthcare leverages a problem-oriented medical record:
“When we went live with [MEDITECH] Expanse, we moved from multiple different EMRs and did a deep dive into problem list management. Understanding that problem lists originated in paper records in the 1970s helped us see their importance,” Dr. Frase explains. “We realized that accurate problem lists are crucial for clinical decision support and improving efficiency. We started with a clean slate, only adding chronic problems, avoiding transient and outdated issues, and eliminating duplicates to maintain relevance and accuracy.”
The idea of treating the “whole” patient and not just the problem
Dr. Frase, who is also a hospitalist, shares her firsthand experience: “With clinical categories, I quickly saw all cardiopulmonary diagnoses, anticoagulation, and kidney problems for a patient needing an emergency procedure. This categorized view allowed me to get a clear snapshot of the patient’s condition, reducing the need to ask the ER doctor many questions. It streamlined my ability to triage and provide immediate care, highlighting duplicates for easier cleanup.”
How does IMO Health operate in the backend?
Dr. Thompson explains, “We analyzed millions of real-world problems to determine the categories, focusing on ordinary physiological systems like pulmonary and eye, along with crucial areas like coagulation and smoking. Deciding where each problem belongs involved input from our clinicians, aiming for clarity without overwhelming complexity.” He continues, “While we strive to listen to feedback and make adjustments, we also maintain a balance between usefulness and practicality, ensuring an efficient system that meets clinicians’ needs.”
Leveraging IMO Core for improved usability and streamlined provider experiences:
“Having IMO Core as a tool to make that cognitive burden of looking at problem lists so much less than what it had been previously is a great way to show providers that we care about the time that they spend with the patients and helps make those problem lists better for patients overall,” Dr. Frase says.
