Department of Medicine 2016 Tech Challenge

New Uses of Information Technology to Advance the Missions of the Department of Medicine

Discharge "To-Do's" Autopopulated in PCP Notes

Idea Status: 

Among the most important components of the hospital discharge summary is the section titled "Follow-up Needs for the Primary Care Physician." This contains specific "to-do's" such as "follow up blood culture results" or "check potassium level in 1 week." These items are often crucial continuations of care needed to close the loop on productive and high-quality hospitalizations. However, they are buried in the bottom of a several page-long discharge summary, making them less likely to be seen and acted on by PCP's. 

For patients who are hospitalized at UCSF and follow up with PCP's on EPIC, there's a better way. Primary care follow up needs can be put in a separate section of the discharge summary - a user-friendly box - that will link directly into primary care notes using a smart phrase. Here's how it works step-by-step:

1. Create a required Primary Care Follow-up box in the inpatient Discharge activity

2. Create a smart phrase that links to the text in this box

3. Encourage PCP's to include the smart phrase in their post-hospitalization note templates

4. To-do's will automatically populate into the Assessment and Plan of primary care notes, making them more likely to be seen and completed.

This change is technically feasible, has the potential to improve patient care transitions, and requires significantly fewer clicks for PCP's, while requiring only one additional click for discharging physicians. 


would also recommend moving the to do for follow-up section to the top of the discharge summary. most of us do read and scroll down, but would appreciate seeing this at the beginning when we are seeing our patients for post-discharge follow-up.

We are building a cardiology outpatient recovery (COR) transitions clinic slated to open in the spring.  In addition to being used in primary care, this "to-do" list would be very helpful to the cardiology clinic provider who will be needing to follow up on resident-identified follow up issues.  Nice idea.

Hi Timothy,

We think this is a great idea and something that would be worth discussing with our build team.  Why don't you submit an AC3 ticket for modification of the discharge summary template (needs to be done in collaboration with a SME like Brad Monash) and we can look into ways to make this work.


--Sara, Raman, and the APeX team

Great idea!  If you're still refining this idea, would be super helpful to also build in an automatic link to or autopopulate function for those unexpected, incidental radiology findings / recommendations for follow-up that collect during a hospital admission and the discharge to do box e.g. "8mm nodule on chest CT, recommend repeat chest CT in 3-6 months"  

These are very high risk of falling off the to-do list on discharge summaries, especially for long, complex admissions.

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