Demonstrating the Value of Clinical Informatics to Third-Year Dpt Students through a Quality Improvement Project Using Electronic Health Record Data
A significant gap exists related to physical therapy studentsÕ ability to integrate clinical informatics into their learning and practice. This gap contributes to a lack of development of the essential skillsets to assess and improve patient outcomes and population health. A pilot educational course was created for physical therapy (PT) students to learn and appreciate clinical informatics concepts and apply their knowledge by conducting a retrospective clinical review using electronic health records (EHR) data for quality improvement (QI) initiative project. There were two objectives: 1) learn introductory informatics concepts and how it applies to EHR data; and 2) compare PT clinical practice patterns and health outcomes with current literature using EHR data.
Three DPT students with no prior informatics experience were selected for this elective course. There were two learning areas for this pilot course: 1) introduction to key concepts of informatics and EHR functionalities using a hybrid learning approach; and 2) learners-led QI project evaluating Subacromial Impingement Syndrome (SAID) population from periods of 2016-2018, comparing actual clinical practice patterns from PT Faculty Practice to evidence-based practice guidelines. Outcome metrics included: health status, visit counts, percentage of goals met, patient-reported outcomes (PROs), pain scale, and PT interventions. Informatics concepts such as data types (i.e., unstructured vs. structured), data quality, and data validation were taught through a didactic method with examples of EHR data. Supplemental online modules were offered for advanced topics such as text mining. The hands-on learning was through a virtual EHR lab. Learners analyzed structured data and applied their clinical knowledge to organize unstructured treatment interventions into appropriate categories using Natural Language Process (NLP) software to determine frequencies and trends.
Learners completed the first iteration of the QI project in eight weeks. Data were analyzed from over 130 patients representing 70+ unique PT interventions derived from unstructured text. Learners noted that patients who had fewer visits had a higher rate of receiving interventions that were recommended from literature compared to those who received more visits. All other outcome metrics were consistent with observations from the literature except PROs were incomplete in some of the patients evaluated. Results and study limited were shared among clinical faculty and second-year DPT students to further expand to demonstrate value of informatics into a larger audience.
Conclusions/Relevance to the conference theme:
DPT students without any prior informatics experience are capable of completing a QI project with appropriate provisioning of technologies and EHR data. By learning informatics concepts and utilizing available technologies, learners became adept at analyzing individual interventions and variations in clinical practice. Engagement of DPT students in clinical informatics through a QI project can positively impact patient care in the faculty practice and enrich student and faculty learning, and improve the learning health system.