Background: While electronic health records (EHR) bring various benefits to health care, EHR systems are often criticized as cumbersome to use, failing to fulfill the promise of improved health care delivery with little more than a means of meeting regulatory and billing requirements. EHR has also been recognized as one of the contributing factors for physician burnout. Objective: Specialty-specific EHR systems have been suggested as an alternative approach that can potentially address challenges associated with general-purpose EHRs. We introduce the Epilepsy Tracking and optimized Management engine (EpiToMe), an exemplar bespoke EHR system for epilepsy care. EpiToMe uses an agile, physician-centered development strategy to optimize clinical workflow and patient care documentation. We present the design and implementation of EpiToMe and report the initial feedback on its utility for physician burnout. Methods: Using collaborative, asynchronous data capturing interfaces anchored to a domain ontology, EpiToMe distributes reporting and documentation workload among technicians, clinical fellows, and attending physicians. Results of documentation are transmitted to the parent EHR to meet patient care requirements with a push of a button. An HL7 (version 2.3) messaging engine exchanges information between EpiToMe and the parent EHR to optimize clinical workflow tasks without redundant data entry. EpiToMe also provides live, interactive patient tracking interfaces to ease the burden of care management. Results: Since February 2019, 15,417 electroencephalogram reports, 2635 Epilepsy Monitoring Unit daily reports, and 1369 Epilepsy Monitoring Unit phase reports have been completed in EpiToMe for 6593 unique patients. A 10-question survey was completed by 11 (among 16 invited) senior clinical attending physicians. Consensus was found that EpiToMe eased the burden of care documentation for patient management, a contributing factor to physician burnout. Conclusions: EpiToMe offers an exemplar bespoke EHR system developed using a physician-centered design and latest advancements in information technology. The bespoke approach has the potential to ease the burden of care management in epilepsy. This approach is applicable to other clinical specialties.

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中文翻译：

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定制的癫痫护理电子健康记录（EpiToMe）：开发和定性评估

背景：电子健康记录（EHR）为医疗保健带来各种好处，但人们常常批评EHR系统使用起来很麻烦，无法满足改善医疗保健提供的承诺，而仅能满足监管和计费要求。EHR也被认为是造成医生倦怠的重要因素之一。目标：已经提出了特定于专业的EHR系统作为一种替代方法，可以潜在地解决与通用EHR相关的挑战。我们介绍了癫痫跟踪和优化管理引擎（EpiToMe），这是用于癫痫护理的示例定制EHR系统。EpiToMe使用以医生为中心的敏捷开发策略来优化临床工作流程和患者护理文档。我们介绍EpiToMe的设计和实现，并报告其对医生倦怠的效用的初步反馈。方法：EpiToMe使用锚定于域本体的协作式异步数据捕获接口，在技术人员，临床研究员和主治医生之间分配报告和文档工作量。只需按一下按钮，即可将文档结果传输到父级EHR，以满足患者护理要求。HL7（2.3版）消息传递引擎在EpiToMe和父EHR之间交换信息，以优化临床工作流程任务，而无需输入冗余数据。EpiToMe还提供实时的交互式患者跟踪界面，以减轻护理管理的负担。结果：自2019年2月以来，共有15417个脑电图报告，2635个癫痫监测单位每日报告，在EpiToMe中完成了针对6593位独特患者的1369个癫痫监测单元阶段报告。由11位（其中16位受邀）高级临床主治医师完成了10个问题的调查。人们发现，EpiToMe简化了患者管理的护理文档，这是造成医生负担枯竭的一个因素。结论：EpiToMe提供了以医生为中心的设计和信息技术的最新发展而开发的示例性定制EHR系统。定制方法有可能减轻癫痫病护理管理的负担。这种方法适用于其他临床专业。人们发现，EpiToMe简化了患者管理的护理文档，这是造成医生负担枯竭的一个因素。结论：EpiToMe提供了以医生为中心的设计和信息技术的最新发展而开发的示例性定制EHR系统。定制方法有可能减轻癫痫病护理管理的负担。这种方法适用于其他临床专业。人们发现，EpiToMe简化了患者管理的护理文档，这是造成医生负担枯竭的一个因素。结论：EpiToMe提供了以医生为中心的设计和信息技术的最新发展而开发的示例性定制EHR系统。定制方法有可能减轻癫痫病护理管理的负担。这种方法适用于其他临床专业。

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