P094 Printing to paperless: improving reporting of high complexity immunogenetics single antigen bead data to the electronic medical record- design of a state of the art reporting system and process improvement

Aim The UCLA Immunogenetics Center (UIC) uses HistoTrac for transplant patient data storage, analysis and reporting to UCLA Health System’s EMR EPIC:CareConnect. Currently, paper reports are uploaded from UIC to EPIC as a scanned PDF. To improve reporting workflows from HistoTrac to the EMR, we developed and mapped components in EPIC:CareConnect to allow numeric reporting of Single Antigen Bead (SAB) reports from HistoTrac. Methods A new State of the Art reporting workflow (Figure 1a) was designed and validated in the test environments. The build was completed for multiple orderables: SAB Class I, Class II or Class I/II combo, and modifications- titration and C1q (specificity, strength/MFI’s and interpretative comments). Results After migration of the reporting workflow to the live environment, baseline system performance data evaluated over a 9 week period showed that ∼4.5/100 tests were resulting in EPIC as “Preliminary” or “In Process” instead of “Final Result” with only common cause variation (Figure 1b). Classic quality improvement methods were employed to improve the process with the aim of reporting 100% of tests as “Final Result”. An audit system was developed and a Pareto Analysis identified two errors accounting for 79% of common system level failures- Status/Timing Errors, and HL-7 Warning Errors. We used the Model For Improvement for system transformation. Status/Timing and HL-7 Warning Errors were completely resolved through the process improvement. Through the audit process, the remaining common system level failures due to technical errors in ordering/reporting, result delays, and HL-7 Fatal errors are identified and resolved. Continuous monitoring reviled a system level shift with only ∼1.9/100 tests resulting in EPIC as “Preliminary” or “In Process” instead of “Final Result” (Figure 1b). Conclusions The study demonstrates that high complexity SAB bead data can be numerically reported to the EPIC EMR from HistoTrac. Through the process improvement, 100% of tests result to EPIC as “Final Result”. Download : Download high-res image (226KB) Download : Download full-size image