Expanding the reaction picklist in electronic health records improves allergy documentation

To address this need, we developed an enhanced, data-driven picklist using data from Mass General Brigham’s (MGB) data repository.3,5 The MGB Allergy Clinical Consensus Group, which included, physicians, nurses, pharmacists, and quality and safety specialists, identified and selected the most common reactions entered as free text and severe reactions omitted from the EHR reaction picklist after reaching consensus. Because it remains unclear whether expanding the reaction picklist improves allergy documentation, we aimed to analyze the effect of the expanded picklist. [...]there was a 10% decrease in entries without any reactions from phase 1 (28.35%) to phase 2 (25.50%). [...]the more comprehensive picklist also enhanced allergy documentation quality by reducing the number of blank or incomplete allergy entries. Because of missing data, we did not include provider details in this study; however, it has been previously established using MGB data that most entries are entered by nonallergists like nurses and medical assistants.2,3 Phase 1 occurred before the COVID-19 pandemic, whereas phase 2 took place during the pandemic. The follow-up period may not have been long enough to capture the effect of the expanded reaction list, and additional research is needed to explore what factors influence adherence to encoding reactions. Because this study uses MGB data, the findings may not directly translate to other health care systems with differing picklists.