EHR-Incorporated MS Smartform Significantly Cuts Down Patient History Review Time in MS

Shuvro Roy, MD

New data presented at the 2022 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, June 1-4, in National Harbor, Maryland, suggest that a novel tool for data collection, dubbed the MS Smartform, can significantly reduce the time it takes for clinicians to review important data on patients with multiple sclerosis (MS). Importantly, the most time was saved for those individuals with more complex treatment histories.¹

Conducted by Shuvro Roy, MD, clinical fellow, Johns Hopkins University, and colleagues, the small, single-center pilot study assessed the MS Smartform within the Epic electronic health record (EHR) system, which had been implemented at the Allegheny Health Network MS Treatment Center. In total, 43 consecutive patient charts were included in the evaluation, with 2 neurologists completing a 5-question questionnaire that addressed relevant clinical variables both before MS Smartform implementation and 1 month afterward.

Ultimately, the findings showed that for each disease-modifying therapy (DMT) that a patient had been exposed to, there was a 62.2-second (95% CI, 38.0-86.40; P <.001) increase in time reviewing clinical history. The mean time to complete the questionnaire pre-MS Smartform was 219.3 seconds, which was improved to only 80.3 seconds (difference, –142.4; 95% CI, –170.6 to –114.1) post-MS Smartform implementation, a 63% improvement (P <.001).

For individuals who had an increasing number of DMT exposures, there was an even greater reduction in time, with a reduction of 31.4s (95% CI, –47.2 to –15.6; P <.001) for every additional DMT compared with pre-MS Smartform times.

“The reason that we put this together was really to address one of the major challenges of taking care of a patient with MS, and that's the complexity of their care,” Roy told NeurologyLive^®. “When you see a patient with MS, there's a lot you need to keep track of. Relapse history, what medications they've been on, why they've switched therapies in the past, how their MRIs have looked. It's a lot to dig through and it can take a lot of time for every clinic visit. What we did was try to one, streamline that process, and two, to try to standardize that information.”

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Roy explained that the MS Smartform contains information about a patient diagnosis, their status with regard to developing progressive disease, relapse information, lesion locations, medication history, reasons for switching therapies, and length of time on each therapy. Additionally, the form includes information about MRI history, “including which ones have, which ones have had no deletions, and which ones have developed new lesions, and where those might be. Because there is so much information [to review], it can take so long to review that without the chance to just put it all in one place. Having it all there really helps the provider,” Roy said.

This study included total of 43 patients in the review (average age, 49.65 years [SD, 8.71]; 21% male) with a median Expanded Disability Scale Score of 2.5 (IQR: 2-5.5) and a mean number of DMTs utilized of 3 (SD: 1.6).

The MS Smartform is free to use for all Epic EHR users via the Epic Library and can be integrated into Cerner EHR systems. Currently, ongoing multicenter investigations are evaluating the generalizability of the results shown in this study. Roy noted that the data can also be leveraged readily for research purposes and big data assessments.

“With the EHR, so often—certainly, I feel this way at times—physicians feel like they're fighting the EHR and feeling like they're fighting through different processes just to be able to take care of patients,” Roy said. “Our goal was to try to make it into a real tool for providers. The idea is that, now, when you open up a patient's chart, you can go to their MS Smartform and you'll know their entire MS history within really just a few minutes.”

“Honestly, as much as this is a research tool, really, our goal is to get it out there for anyone to use. That's why we went through the EHR. We can help coordinate the incorporations of it as well, where you can get this built into your practice without having to pay or really do anything extra. We're happy to help do that. Our goal is to standardize care for patients with MS across the country, and we felt that going through the EHR—and, really, the largest EHRs—was the best way to do that,” he said.

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REFERENCE
1. Roy S, Grader-Beck T, Mann H, et al. Estimating Time Saved in MS Clinic Using MS Smart Forms to Retrieve Clinical Data. Presented at: CMSC Annual Meeting; June 1-4, 2022; National Harbor, MD.