Research at the Point of Care: Using Electronic Medical Record Systems to Generate Clinically Meaningful Evidence

Abstract

Context: Health care leaders have recommended the use of health information technology to improve the quality of patient care. In athletic training, using informatics, such as electronic medical records (EMRs), would support practice-based decisions about patient care. However, athletic trainers (ATs) may lack the knowledge to effectively participate in point-of-care clinical research using EMRs.Objectives: To discuss the role of EMRs in athletic training and identify methodologic approaches to conducting clinical research at the point of care.

Patients Experience Significant and Meaningful Changes in Self-Report of Function During the First 2 Weeks After an Ankle Sprain Injury: A Report From the Athletic Training Practice-Based Research Network

“…The assessment of patient outcomes has been identified as an integral component of contemporary athletic health care for over a decade. 18,19 Previously, the National Athletic Trainers' Association Position Statement on conservative management of ankle sprains 20 emphasizes the need to use PROMs to help inform return-toplay decisions following an ankle sprain injury. However, recent investigations 21,22 found that there is a lack of consensus regarding which specific patient-reported measure should be used or which scoring thresholds should be used for decision making.…”

Characterizing athletic healthcare: A perspective on methodological challenges, lessons learned, and paths forward

“…Although EMRs can support prospective (e.g., randomized controlled trial) and retrospective (e.g., observational designs) investigations (Cowie et al, 2017 ; Marshall and Lam, 2020 ), we will primarily focus our discussion on the observational design since most of our efforts to date have used this approach (Valovich McLeod et al, 2012 , 2019 ; Lam et al, 2015 , Lam et al, 2016b , 2021 , 2022 ; Marshall et al, 2019 ). In brief, observational data are usually recorded during routine, real-life encounters (Concato et al, 2010 ).…”

“…Although large datasets have supported efforts in sport performance (Seshadri et al, 2019a , b ) and sport epidemiology (Kerr et al, 2018 ; Bohr et al, 2021 ), there have been fewer efforts aimed at understanding the overall impact of athletic health care, including the effectiveness of injury prevention programs and rehabilitation techniques provided by healthcare providers. Point-of-care data collected via electronic records provide valuable insights into these important lines of inquiry by characterizing the care provided to patients and generating point-of-care evidence (Casey et al, 2016 ; Cowee and Simon, 2019 ; Lam et al, 2020 ; Marshall and Lam, 2020 ).…”

Core Competency–Related Professional Behaviors During Patient Encounters: A Report From the Association for Athletic Training Education Research Network

“…To deliver high-quality patient care, ATs must be able to efficiently document the patient care services provided and use that data to make informed decisions throughout the PE. 20 For several years, investigators 17,18,21 have identified a multitude of challenges that prevent ATs from efficiently documenting patient care at the point of care. Challenges such as lack of time, patient volume, available resources, and where care is provided 17,18,21 have affected ATs' perceptions of documentation 18 as well as their documentation behaviors.…”

“…Furthermore, to truly achieve EBP and PCC, it is vital that ATs collect meaningful data that can be effectively used to assist with the clinical decision-making process via high-quality documentation habits at the point of care. 20 Also, greater effort is required to ensure appropriate documentation of patient care and that using patient data to make informed decisions is being modeled to ATSs in the clinical environment. To overcome perceived barriers expressed by ATs and clinical preceptors, including an academic EMR in athletic training education may be valuable.…”