Using information from an electronic health records system, doctors can stratify risk to determine which patients may benefit from acid suppression therapy to counter gastrointestinal bleeding.
An EHR-linked dashboard provided effective clinical decision support by improving interventions for critically ill patients admitted to the intensive care units in an academic medical center.
“Considering the deleterious effects of both under- and overprescribing of acid suppression therapy, particularly in high-risk patient populations, this type of technology may lead to enhanced patient outcomes,” concludes a new Penn Medicine study published in the Joint Commission Journal on Quality and Patient Safety.
The EHR-supported dashboard was developed and implemented with the assistance of Penn Medicine’ s Center for Health Care Innovation, producing significant results. The study reports that “appropriate acid suppression therapy prescribing was improved from 72.9 percent to 86 percent,” according to the health system’s data of inpatients in the Cardiac Intensive Care Unit.
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Acid suppression therapy can reduce some patients’ risk of developing ulcers, such as cardiac patients who are on certain medications that may increase their chance of gastrointestinal bleeding.
“The main reason the patients are at risk is because they’re placed on medications—or combinations of medications—such as anti-platelet agents or anticoagulation,” says lead author Carolyn Newberry, MD, a Penn Medicine gastroenterology fellow at the time the study was conducted, who is currently an assistant professor of Medicine in the division of gastroenterology and hepatology at Weill Cornell Medicine in New York. “These medications are important for treating or preventing cardiovascular disease but they also have side effects such as increased bleeding in the G.I. tract.”
Encouraged by the results of the study, Penn Medicine’ s Center for Health Care Innovation is looking to leverage similar dashboards to help care teams with challenges in other clinical areas.
However, Newberry cautioned that “no one dashboard or technology will work in every area, so it is important to partner with clinicians and identify workflows and processes where it can complement care.” She adds that “our experience highlights this individualized nature and the importance of continued collaboration, along with process redesigns, to achieve sustainable success.”