1. Society Perspective 07 SEPT 2018

2. EHR Landscape 1,100 commercially available EHR systems1
Member survey of ob-gyn EHR usage
survey to members
n=3198
Response rate = 16.7% 1.

3. Unintended Consequences: Physician Burden
Electronic health record use is contributing to physician burnout
As much as 50% of a physicians’ time spent completing clinical documentation - “pajama time”1
Est. 64 minutes per day spent processing EHR alerts2
Documenting to fulfill billing requirements, not enhancing patient care3
1. Shanafelt, TD et al. Mayo Clinic Proceedings 91(7):
2. Murphy, DR et al. JAMA Internal Medicine 176(4):
3. Ommaya, AK, et al. National Library Of Medicine Discussion Paper.

4. ACOG Health IT Initiatives
ACOG Prenatal Record
ACOG Comprehensive Women’s Medical Record
The Birth Registry
Data Modeling Initiative (Revitalize 2.0)
Patient Reported Outcomes
OPA FPAR 2.0

5. Compare the two

6. ACOG Comprehensive Women’s Medical Record
Abnormal Uterine Bleeding
Menopause
Gynecology
Infertility
Well-Woman/
Primary Care
Breast Health
Contraception
Obesity
Heart Health
Family History
Immunization
Sexual Health
Mental Health
Pelvic Pain
Genetics &
Precision Medicine
Urogynecology
Prenatal
Postpartum
Prenatal Genetics
ACOG Comprehensive Women’s Medical Record
Obstetrics

7. Comprehensive Women’s Medical Record
2021
Timeline
ACOG Comprehensive Women’s Medical Record
APR: Continued marketing
Comprehensive: Launch Genetics Module, Develop new modules
2020
APR: Market & Promotion
Well Woman: Launch Well Woman and modules, Develop Genetics module
2019
APR: Additional EHR Platforms
Well Woman: Develop Well Woman, Pelvic Pain, Abnormal Uterine Bleeding modules
2018
2017
APR: In Production

8. USPSTF Levels I: At least one properly designed RCT
II-1: Well-designed controlled trials without randomization
II-2: Well-designed cohort or case-control analytic studies, preferably from more than one center or research group
II-3: Multiple time series with or without intervention. Dramatic results in uncontrolled experiments also could be regarded as this type of evidence
III: Opinion of respected authorities, based on clinical experience, descriptive studies, etc

9. Recommendations A: Good and consistent scientific evidence
B: Limited or inconsistent evidence
C: Primarily on consensus and expert opinion

10. Overarching Issues Real World Evidence
Federated Data Model vs. Harmonization
Value Set Issues
Missing data (coded, built, & used)
Device-Centered vs. Patient-Centered
Clinical workflow
Data sharing/movement

11. Uterine Fibroids Predictive analytics for customized patient care:
Shortest Symptom to Relief Time
Best, Long-term Outcomes
Least Invasive
Managed Expectations/Counseling
Cost-effective
This slide is what ACOG wants out of the data

12. Sterilization and LARC
Specific patient populations (eg, women with obesity, hypertension, etc)
Physician technique (procedure and counseling)
Physician practice patterns
Adverse events (ectopic pregnancies, long term ovarian cancer risk, patient reported outcomes)
Future procedures (hysterectomies)
This slide is what ACOG wants out of the data.