Providing Nutrition Support in the Electronic Health Record Era: The Good, the Bad, and the Ugly

Background: Data are not available on the quantity or quality of nutrition support content in the currently available electronic health record (EHR) systems. Materials and Methods: A survey study of the American Society for Parenteral and Enteral Nutrition membership regarding the safety and efficacy of nutrition documentation and the ordering process for oral diets, oral supplements, tube feedings, and parenteral nutrition in currently used EHRs was conducted. The responses were converted to a rating of excellent, good, fair, poor, or unacceptable for each component. Results: The survey responders rated all 5 of the above EHR nutrition components only as fair. There were no differences between disciplines regarding how they rated these nutrition components. The responders who had been using their EHR for more than 10 years rated these components as fair to good, which was significantly better than those responders who have been using their EHR for less than a year, who rated these components from poor to fair. There was some variation in ratings given to the 7 different EHR vendors used by the responders, with 2 vendors having significantly poorer ratings than the other vendors. However, even the top-rated vendors received ratings of only fair. Conclusions: This study should be a wake-up call for EHR developers/vendors, healthcare systems, and clinicians that the nutrition and nutrition support content of the current EHRs needs significant improvements. Nutrition support clinicians need to be actively involved in optimizing this EHR content. (Nutr Clin Pract. 2012;27:718-737)