Advance electronic screening of patients with cancer leveraging a new EHR to increase efficiency of care delivery, driving clinical care pathways in a perioperative anesthesia assessment center (PAAC), at a comprehensive cancer center.

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308 Background: Most cancer institutions are using electronic health records (EHRs). With MACRA and MIPS, this number will continue to grow. EHR’s can be frustrating as some are seen as more cumbersome than useful to patient care delivery. In 2017, the MD Anderson cancer center (MDACC) PAAC assessed over 20,000 patients. We wanted to demonstrate positive utility of our EHR. We hypothesized that advanced electronic screening of our cancer patients, leveraging a questionnaire embedded in the EHR, could increase efficiency by driving patient specific perioperative care pathways leading to positive patient experience while not negatively affecting our low same day surgery cancellation rate of 2.07%. Methods: In March of 2016, MDACC launched a new EHR and the PAAC commenced an online medical and anesthesia screening questionnaire to be completed via a secure online portal by our cancer patients in advance of the surgery date. The questionnaire was developed and vetted by specialists from many areas including anesthesia, cardiology, internal medicine, and surgery. The answers to these questions were validated by a healthcare provider, and the patient was directed to one of two care pathways. Complex patients were scheduled for an in person clinic assessment prior to surgery and all other patients were scheduled for a phone call assessment. We used reports created within our EHR to track baseline and 2017 data for numbers of patients directed to the 2 different pathways and same day surgery cancellation data throughout this time frame. Results: Using the online patient entered questionnaire, we were able to improve clinic efficiency by implementing two patient care delivery pathways. Using our new EHR we saw an increase of 18.4% in our phone assessment pathway for patients. Patient experience improved as we were able to offer patients more options in the delivery of care saving them time. Conclusions: Use of our new EHR and IT analytics helped drive patient-specific care pathways, improve efficiency and the patient experience. MDACC same day surgery cancellation rate remained 2.07%.

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