Podcast Summary: Leveraging EHRs to Close Gaps in Postmenopausal Osteoporosis Care

Podcast: Becker’s Healthcare Podcast
Date: December 1, 2025
Host: Erica Spicer Mason (Becker’s Healthcare)
Guest Speakers: Kristen Buessman (Amgen), Dr. Barry Wendt (Chief Medical Information Officer, St. Elizabeth Healthcare)

Episode Overview

This episode explores how health systems can leverage advanced Electronic Health Record (EHR) functionalities—specifically Diagnosis Aware Notes (DANs)—to close care gaps in postmenopausal osteoporosis management. The discussion highlights St. Elizabeth Healthcare’s strategies for utilizing EHR innovations to guide clinicians using up-to-date guidelines, improve documentation, streamline workflows, and ultimately provide better population health outcomes for a commonly under-treated patient group.

Key Discussion Points and Insights

The Burden of Osteoporosis in Health Systems

• St. Elizabeth Healthcare Background
  • Large Midwestern health system with over 800 providers; recognized for top physician EMR satisfaction.
  • High prevalence of postmenopausal osteoporosis; many women remain undertreated even after diagnosis ([01:52]).
• Clinical Challenge
  • “Many women are undertreated and we find that even though they're diagnosed, sometimes they're just put on calcium, vitamin D and given exercise, but not really put on the adequate therapy that they need.” — Dr. Barry Wendt ([02:25])
  • Multiple new drug classes and evolving guidelines over the past decade make it hard for clinicians to keep up.
• Consequences
  • After an osteoporotic fracture, postmenopausal women are five times more likely to suffer another fracture; this risk persists lifelong ([03:18]).

Leveraging EHR: Diagnosis Aware Notes (DANs)

• Problem-Oriented Charting in EPIC
  • Introduces a documentation workflow based on specific conditions, integrating smart text and clinical decision guidance ([04:45]).
  • DANs are “notes that follow a more natural workflow for the provider. They can document the way they did years ago with writing on paper in a natural workflow.” — Dr. Wendt ([04:52])
• Smart Text Integration
  • Automatically inserts guideline-driven recommendations and templates associated with the diagnosis.
  • Reduces documentation time and cognitive load ([05:35]).
  • “Embedded within that smart text, we're able to put guideline driven decisions that nudges providers to do the right thing.” — Dr. Wendt ([05:09])
• Comparison to BPAs (Best Practice Advisories)
  • DANs provide non-disruptive guidance, avoiding the interruptions of pop-up advisories ([06:07]).
  • “It's decision making within that smart text...not only does it greatly speed up their time documenting, but it reduces their cognitive effort.” — Dr. Wendt ([06:18])

Impact on Osteoporosis Care

• Guideline Compliance and Workflow
  • Improved adherence to updated treatment and testing recommendations for osteoporosis.
  • “We're finding much more compliance with the guidelines than we were prior to having these in place.” — Dr. Wendt ([07:19])
• Enhanced Documentation and Patient Follow-Up
  • Automatic prompts for missing lab orders (e.g., vitamin D levels), ensuring completeness ([07:39]).
  • “If a patient hasn't had a vitamin D level checked, then the provider is immediately aware...and will place an order.” — Dr. Wendt ([07:47])

Implementation Advice

• Setting Up DANs
  • Simple to build; easier than digesting clinical guidelines.
  • “It takes less time to read the guidelines than it does to build these inside our EHR.” — Dr. Wendt ([08:33])
  • Steps: Build the template to fit guidelines, associate with a diagnosis grouper (e.g., diabetes), and configure preferred options to default in ([08:40]–[09:16]).

Integration Challenges and Future of EHR Technologies

• Provider Acceptance
  • Main challenge is avoiding workflow disruptions; DANs are popular for their seamless integration ([09:41]).
  • “Providers don’t like disruptions during their workflow. The great thing about these is they're non disruptive, unlike the pop up BPAs.” — Dr. Wendt ([09:45])
• AI in Healthcare
  • Caution expressed around overreliance on AI, which may not consistently enforce guidelines like curated templates do ([10:04]).
  • “The problem I see is the AI might not pick up the appropriate guidelines or might not walk you through the steps...These are truly curated steps.” — Dr. Wendt ([10:13])
• Guideline-Driven Innovation
  • Emphasis on blending new technologies with clinically-informed pathways and provider expertise ([10:49]).

Notable Quotes & Memorable Moments

• Importance of Proper Therapy
  “Many women are undertreated...but not really put on the adequate therapy that they need.” — Dr. Barry Wendt ([02:25])
• EHRs as Partners in Care
  “Diagnosis aware notes are extremely easy to use...takes minutes really to build these out.” — Dr. Barry Wendt ([08:57])
• Balancing Technology and Clinical Wisdom
  “I’m concerned...we’re going to be too reliant on AI and AI might not provide the correct answer. So I think that’s where [diagnosis aware notes] have a significant advantage...” — Dr. Barry Wendt ([10:16])

Timestamps for Key Segments

| Timestamp | Segment Description | |------------|--------------------------------------------------------------------------------------------------| | 01:52–04:06| Dr. Wendt outlines St. Elizabeth’s scope and the challenges/impact of osteoporosis | | 04:39–06:40| Dr. Wendt introduces Diagnosis Aware Notes and their practical advantages in EHR documentation | | 07:04–07:24| Specific improvements in guideline compliance using DANs | | 07:39–08:03| Example: Incorporation of vitamin D checklist and exercise guidance into notes | | 08:27–09:25| Practical advice on implementing DANs into health system workflows | | 09:41–10:49| Challenges of EHR integrations, limits of AI, and the case for provider-driven technology |

Conclusion

Summary:
St. Elizabeth Healthcare’s use of Diagnosis Aware Notes transforms EHR workflows, making it easier for clinicians to adhere to current osteoporosis guidelines, document care comprehensively, and bridge critical care gaps for postmenopausal women. The episode balances optimism for EHR innovations with notes of caution regarding disruptive alerts and overreliance on AI, arguing for human-guided, guideline-driven technology solutions.

Final Word:
“Using technology, resources and innovations...needs to be informed by clinical guidelines and the knowledge of our provider community.” — Kristen Buessman ([10:49])