The solution is the problem list

A problem list is part of the electronic health record (EHR) and includes patients’ current and past medical conditions, diagnoses, and other relevant health issues. Only once data on problem lists in EHRs are complete, standardized and correctly structured, one can profit from potential EHR benefits such as having the complete overview of patient problems, decision support and secondary use of problem list data.
Unfortunately, current problem lists remain incomplete and contain duplicate diagnoses or even wrong information. This could distract a provider, reduce efficiency or potentially lead to inappropriate actions. Acceptance and actual usage of the problem list is more likely when the system provides direct incentives to healthcare providers, particularly if it saves time and efforts and improves patients’ outcomes. However, there is little evidence whether a patient record with a correctly structured problem list results in time and effort saved.
The primary objective of this thesis is to investigate problem list usage patterns and identify opportunities for improvement that maximize its utility. More specifically, to investigate whether a correctly structured problem list can provide significant benefits to healthcare providers.
This thesis shows that the problem list is a meaningful tool and provides significant direct benefits to the healthcare provider and to safety of patient care. However, we cannot rely on problem list data for (re)use due to several barriers. A combination of several interventions to improve the problem list usage is needed, which requires national regulations and significant effort from all stakeholders involved in patient care.