Success Stories, Accomplishments and Progress of the LHS

This page highlights the success stories, accomplishments, and improvements that are a result of the PM&R Learning Health System (LHS) work.  

NeuroSport’s New NoteWriter Template – Standardization that Works!

Published on September 28, 2018

Over the summer, the NeuroSport Team rolled out the NeuroSport standardized concussion exam template in NoteWriter (.neurosportexam). The Team reports that although it still needs some minor tweaks, they like it a lot!

This template allows all NeuroSport physicians to more quickly and easily enter standardized notes, while also providing essential individual flexibility.

For those who are unfamiliar with NoteWriter, it is an Epic tool that incorporates SmartBlocks, SmartTools and Free-Text to allow clinicians to quickly compose notes by clicking buttons instead of typing. As clinicians click to record patient information, the NoteWriter generates corresponding text. Clinicians can then review the text and add information as needed before signing the note.

The entire NeuroSport Team worked together to design and refine their concussion exam template with their MiChart builder, in an iterative process of in-person and online meetings and communications. The result is an effective, user-friendly, standardized tool that makes documentation better and faster. It also provides discrete data fields that can be easily pulled to create a variety of reports, graphics and our LHS!

If you are interested in learning more about NoteWriter and other Epic tools, you can join the Epic UserWeb. Simply go to and set up your free account as a part of Michigan Medicine. It just takes a minute!

-Gina Jay


What I Learned on My Way to Building an LHS – Observations from the Hand Therapy Team

Published on September 14, 2018

The Hand Therapy Team was one of the earliest adopters of the LHS initiative and has been working away for some months now. They have been kind enough to share some of their observations and experiences with others who have not yet started their LHS journey.

From members of the Hand Therapy Team:

“I really enjoy doing this as a team, especially so far… we chime in with our ideas in a judgment free zone.”

Thinking about how their experience with the LHS has impacted their work:

“I am definitely using the Flowsheet in my documentation of PRWHE (Patient Rated Wrist/Hand Evaluation) answers when I wasn’t doing so before [LHS] in MiChart. It’s so nice to look back at previous answers and share progress with the patient on areas of improvement.”

“I feel really good about working on this project, as it will have a direct effect on my documentation in the future, it will allow for gathering of information that we have not previously had, and I do like to share with patients who ask, what the “normal” outcome is for a given injury. I’m excited about the prospects of LHS.”

Jasmine Krishnan, OT, sums up her views on the PMR LHS:

“I feel that the LHS initiative will be significant in the utilization of collective wisdom in the healthcare community. With standardization of documentation and processes as a fundamental building block, it has the potential for informing future research, while providing data for consideration when evidence-based published literature is not available. With the long term larger goal of inter-organizational compatibility, laying down first building blocks in the hand team, here in Michigan Medicine has been stimulating. Personally, I have found the range of variation in our documentation eye opening. The process of standardization is a laborious one. I feel that the effort will be fruitful in the long run.”

Even in the earliest stages of building their LHS, the team has learned a great deal that they can apply to their everyday work, and are excited at the enormous future potential.  Kind of inspiring, huh?

-Gina Jay