Identifying Patients with Breast Cancer History Using Epic Electronic Health Record

Abstract

Introduction: Identifying patients with a history of cancer in primary care remains a barrier to implementing optimal survivorship care.

Methods: As part of an intervention to support primary care practices to deliver breast cancer survivorship care, our team developed a process that uses electronic health record (EHR) reporting capabilities to systematically identify patients with breast cancer history. This intervention was fielded in 13 primary care practices in an integrated health system. End-user feedback throughout the intervention informed refinements of the procedure and provided insights into the appropriateness and feasibility of implementing this tool.

Results: Practice members were able to successfully generate reports that included lists of patients with a history of breast cancer at both the practice and clinician level. Feedback from those implementing the intervention led to refinements that included expanding users who could generate and access the reports to include nonphysicians and adding additional search criteria.

Discussion: Implementation of system-wide EHR reports and instruction of clinic champions on procedures to generate analytics of breast cancer survivors can facilitate informatics skill-building and enable primary care teams to engage in breast cancer survivorship care.

Conclusion: This method of creating practice- and clinician-specific cancer survivor patient registries can be applied in other contexts to support the delivery of evidence-based survivorship care.

Keywords: Breast Cancer; Cancer Survivors; Electronic Health Records; Human Centered Design; Implementation Science; Medical Informatics; Organizational Change; Primary Health Care; Quality Improvement; Registry Data.