What is Rule Authoring in an EHR?

I should probably start with a definition for rule authoring if you are not a familiar with the concept of how an EHR is able to alert or prompt physicians inside the application.

I define “Rule Authoring” in EHRs as a system for creating alerts or prompts, emails, directing the user to a specific area in the application, logging an event in the application, or activating a web service when an event or action in the application occurs from a defined or specific patient(s), user(s), or encounter(s) or something else defined by users.

Or simply defined, if this happens, then do this or that–but PLEASE don’t make me have to be a software programmer, talk like one, or ask one to figure that all out for me because I need it in the EHR now. Our system does that and more. If you want to see that demonstrated, click here to request a demo.

The Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR) has a number of different tools you will not find in a traditional EHR / EMR, let alone one dedicated to education and learning used in medical schools and allied health professions education. Our clinical system that the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR) is a branch of has rule authoring capabilities built inside for non-programmers and clinicians to create rules and alerts to improve patient care. We have adopted that functionality for educators to create prompts within the system that has a ripple effect for students to promote learning at any place inside the system.

Why a Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR)?

The typical case presentation is done using paper today. It has a vignette that the student reads about the patient before providing them with the fake patient record to review and report out on for the learning exercise. This way of teaching students is very popular and has been done this way for a long time. I think we can all agree that education is evolving. It has to evolve. The Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR) team has developed a system for doing case presentations, among other learning paths, using an EHR/EMR.

The Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR) team has developed a unique system for doing case presentations, among other learning paths, using an EHR / EMR. While using and EHR / EMR is not necessarily unique to students, how we have adopted our clinical decision support rules engine for learning combined with the evaluation tools for education is unique. We give educators the ability to create vignettes, prompts, rules, alerts, and provide links out to other educational content for learning. From what we have seen and heard, no other EHR/EMR for learning can do what we have done for education.

Putting It Into Practice

As an example, students receive a prompt when they select a patient from the dashboard. Students receive a vignette of the patient and the learning objective that the educator would like for the student to walk through.

One traditional implementation of this for exercises inside or outside the classroom is for students to get prompted when they select a patient from the dashboard. The ‘patient story’ or vignette of the patient and the learning objective asks the students to read and select continue to acknowledge their completion (see screenshots) by selecting “Continue.”

The student is then able to explore the anonymized patient and write reflection notes to communicate with their teacher.  Our system tracks the student’s activity and interactions inside the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR) and can be reported and analyzed. The evaluation capabilities are extremely valuable for both the student, educators, and administrators because the activity records can highlight student performance consistently across lessons, classes, years, campuses–all the while simulating activities they will all perform in clinical practice.

One thing you might notice about the ‘patient story’ above is the alert that is a popover, and on the right side, you will see that we have the ability to provide a persistent window for students of the information after they have closed out the popover by selecting ‘continue.’ This

Better Evaluation

In the example below, you can see that I’ve not done a great job of navigating the patient’s record and completing the “gold standard” objective of reviewing and creating orders for the patient inside the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR). Your students are going to do better than my 4 out of 18 or 22% performance on this exercise that was built with our RAVE (Rule Authoring and Validation Environment) inside the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR). The great news is that I can see the areas where I missed diagnosed and failed to put in the gold standard of orders in the patient lesson.

If we school down and look a little closer, you can see the additional resources as a learner that I have been asked to review the topics covered in this lesson to ensure that I captured all the learning points and will help to ensure that I don’t perform so poorly in the future.

The RAVE applications in the curriculum are only limited by my imagination. The team is actively working on some standard rules that we will share or you can easily create your own inside the administration toolkit inside of the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR application)–without needing a degree in computer science which is helpful for me and many of the faculty members, researchers, and clinicians that are already using RAVE.

We would love to have a discussion with you on you might use the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR) with your students on your campus and how tools like our RAVE can promote and enhance learning.

Please contact a representative or me, Brian Stout, to learn more.

Brian Stout
Sr. Product Manager
Regenstrief Institute – Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR)

 

 

 

About the Author

Brian Stout is a senior leader in marketing and product at the Regenstrief Institute in Indianapolis. He is an authority on using EHRs in Medical and Allied Professions Education. He leads product for one of the nation’s most seasoned (since 1972) and innovative electronic health record platforms in the country. An advocate for learning and professional development, he is continuing his education with a Masters in Data Science from Indiana University in the Fall of 2017. You can follow him on Twitter @TeachingEMR and LinkedIn or other social platforms under ThinkStout.