Electronic Health Records

Use & Optimization News

EHR Use Assists Warfarin Patients during Transitions of Care

A new study from the University of Missouri Health Care determined EHR use can be valuable in improving patient care for patients requiring warfarin management.

By Kate Monica

- In a recent study, MU Health Care found that EHR use can be useful in improving anticoagulation therapy between outpatient and inpatient settings and across providers.

Study shows EHR implementation improves patient outcomes in transition of care.

Researchers conducted the study in response to challenges arising from transitions of care from in-hospital to post-hospital during warfarin management.

Providers have historically struggled with warfarin management, resulting in a variety of problems including dosing errors, medication nonadherence, and insufficient monitoring.

Furthermore, researchers noted a trend of adverse drug events following transitions of care caused detrimental outcomes. A lack of awareness on the part of the patient could lead to seemingly innocuous mistakes leading to more serious repercussions.

  • Financial Challenges, MU Complexity Stunting EHR Integration
  • Health Data Exchange, Standardization Lacking in Chronic Care
  • CA Hospitals Agree to Connect to Health Information Exchange
  • CareMore, Emory collaborate on value-based care model
  • ONC continues push for Blue Button during National HIT Week
  • AMA Leads Call for Addressing EHR Quality Reporting Programs
  • Senate HELP Committee to Hone EHR Use, Interoperability Laws
  • Ohio Hospital Improves Patient Outcomes Using EHR Technology
  • 3 Best Practices For Effective EHR Replacement, Adoption
  • DirectTrust Recommendations Encourage EHR Interoperability
  • Promise of big data closely tied to EHR adoption, usability
  • New Minn. Bill Seeks to Remove EHR Interoperability Mandate
  • Advanced EHR Use Shows Potential to Lower Patient Costs
  • Top technical safeguards for health data security
  • Medical scribe certification may ease EHR data entry burdens
  • CIOs Set to Channel Future Spending Toward EHR Optimization
  • The Week Ahead in Health IT Interoperability: Jan. 11-17
  • Medication Data in EHR Provides Basis for Tracking Adherence
  • Vendors, CDI, Revenue Cycle Woes at Heart of ICD-10 Concerns
  • Early Look at the ONC Nationwide Interoperability Roadmap
  • Three Vendors are Driving Patient Engagement and Portal Use
  • Does Healthcare Fraud Impact Meaningful Use Audits?
  • McKesson Wins $400M DoD Imaging Health IT System Contract
  • 12 EHR Vendors Reach Agreement on Interoperability Standards
  • DirectTrust Hopeful for Impending ONC EHR Certification Rule
  • Few Providers Satisfied with EHR System Success in QPP
  • Key Takeaways to Support a Successful MACRA Implementation
  • ONC video explains meaningful use transitions of care (ToC)
  • UPDATE: Final Rule for Meaningful Use Modifications Under Review
  • AMIA: “Unprecedented Opportunity” with MACRA Implementation
  • Lawsuit Questions Electronic Health Record Sharing Costs
  • ICD-10 Best Practices: Education and training
  • Collaborative, accountable care continues its national rise
  • What role can health information exchanges play in big data?
  • Providers Still Facing Health Information Exchange Barriers
  • UVM Medical Center Seeks Approval for Integrated Epic EHR
  • Call for EHR Companies to Provide No-Cost EHR System Updates
  • CHIME Supports for Potential EHR Meaningful Use Changes
  • Should physician societies endorse and approve mHealth apps?
  • New eHealth University contains tools for ICD-10 transition
  • Getting to the crux of meaningful use
  • Interoperable, Standard Health IT Key for Quality Improvement
  • Are we about to see the end of the complete EHR?
  • Stage 1 Meaningful Use full payment deadline coming soon
  • Major Healthcare IT Topics to Watch Out for at HIMSS15
  • ONC Finds Meaningful Use Prompts Public Health Reporting
  • ICD-10 may have to coexist with ICD-9 for successful switch
  • Meeting Meaningful Use Requirements for Transitions of Care
  • GAO highlights low participation in Medicare EHR Incentive Program
  • High rural REC enrollment, partnerships help EHR adoption
  • How SMART is your health IT system?
  • AHA Seeks Changes to EHR Certification, Quality Reporting
  • VA Hearing Confirms Plan to Adopt Commercial EHR Technology
  • EHR Adoption, EHR Use More Effective in Team-Based Settings
  • Big Data Approach to Cancer Drug Discovery Adds 3D Details
  • Will Carequality Lead EHR Vendors to EHR Interoperability?
  • Industry experts voice plans for making good on ICD-10 delay
  • Tailored Physician EHR Use Necessary for Evolving Industry
  • 257K Meaningful Use EPs to Get Medicare Payment Adjustments
  • Why You Should Support the Safe Harbor ICD-10 Conversion Bill
  • HIMSS ICD-10 Taskforce: Don’t underestimate time, complexity
  • How to avoid choosing the wrong healthcare analytics tool
  • CIO series: Epic EHR adoption, training at a Stage 6 hospital
  • National eHealth Collaborative releases patient engagement framework
  • Patient Engagement, mHealth among Top Health Issues in 2015
  • Should ONC decertify EHRs that block interoperability?
  • Handwritten orders bypass EHR alerts at VA, cause three deaths
  • NCQA Recommends 11 Changes to Quality Payment Program Rule
  • Do EHR Implementations Have Negative Short-Term Effects?
  • Centura Health Earns Davies Award for IT Excellence
  • EHR vendor consolidation: What does the future look like?
  • EHR Implementation Projects Impact EHR Optimization Efforts
  • Telehealth roundup: Trauma, transitions, and home treatment
  • CMS Seeks Specific Comments on Stage 3 Meaningful Use Rule
  • How does health IT ensure the success of reporting programs?
  • 3 Hospitals Recognized for Highest Level of EHR Adoption
  • Top EHR Twitter resources
  • New VA leader targets interoperability, efficiency as goals
  • mHealth World Congress: Cleveland Clinic on mobility
  • Enabling patient access, understanding through patient portals
  • How Inbound Data Changes Health IT Interoperability Strategy
  • VA Receives $65M in Funding for Cerner EHR Implementation
  • Mental health providers want patient tracking, all-in-one EHRs
  • Study: Electronic health records don’t increase Medicare fraud
  • Black Book Sees Rise of Private Health Information Exchanges
  • Pennsylvania Medicaid earning its stripes
  • Study: Telehealth raises satisfaction, reduces hospital stays
  • False congratulations on the road to meaningful use
  • Rural California turns to mobile health IT for patient support
  • Yale-New Haven’s Epic EHR experiences temporary glitch
  • IBM, Carilion Clinic detect patients with heart failure risk
  • CDI produces financial, clinical benefits apart from ICD-10
  • Why the Healthcare Cloud Holds the Key to Future Innovation
  • How is HIE use best incorporated into clinical workflows?
  • Unhappy lawmakers take aim at VA, DoD plans to nix joint EHR
  • Five questions to ask before considering EHR replacement
  • Kaiser Permanente pays $4M for mental health care violations
  • Mayo uses mHealth to reduce cardiac readmissions by 40%
  • Can Natural Language Processing Boost Clinical Documentation?
  • Listening in the clinic: Meaningful use and patient engagement
  • For example, the commonly-used blood thinner, when mixed with vitamin K, can have severe consequences. Vitamin K is prevalent in foods such as lettuce and broccoli. Without proper outpatient monitoring, unknowing patients could subject themselves to a dangerous chemical cocktail and put themselves at risk.

    Fortunately, the MU Health Care study found EHR use could prove useful in mitigating confusion among providers and pharmacists after patients are discharged, leading to better monitoring of patient care and more accurate dosage.

    "Previous research indicates that adverse effects of warfarin accounted for 33 percent of annual emergency hospitalizations for patients 65 or older in the United States," said primary care physician and leader author Margaret Day, MD, who also serves as Medical Director at MU Health Care's Family Medicine-Keene Clinic. "At MU Health Care, we designed the 'Outpatient Warfarin Management Order' record in response to The Joint Commission's call for institutions to reduce possible patient harm associated with the use of warfarin."

    Prior to the study, physicians specified warfarin management plans manually on paper according to their personal practice preferences at the time of discharge. As of November 2010, EHR technology revolutionized this system by instead utilizing a computerized order entry.

    The modified EHR workflow created an order prompting physicians to include five elements for warfarin management upon discharge. This study assessed the impact of this intervention as a means of communication between patients and healthcare providers.

    The MU Healthcare EHR system generates a health summary for each patient including a full medical history. Researchers found the discharge summary was particularly useful in communicating the five elements for successful warfarin management.

    The five elements necessary to proper warfarin management include expected duration of treatment, date anticoagulation started, and concurrent treatment, among others.

    Researchers concluded that all five elements were included in the discharge documents of 42 percent of patient charts before the intervention in comparison to 78 percent of charts after the intervention.

    Additionally, researchers found that individual elements were included in patient charts between 84 percent and 94 percent of the time following the implementation of EHR systems in outpatient monitoring.

    "Of the 28 physicians and pharmacists who took part in the survey, 61 percent said that the new warfarin order was 'user friendly and accessible,'" Day remarked.

    A record review team of authors and pharmacy students reviewed post-discharge orders and discharge summaries for each patient to indicate whether the five key elements for warfarin management were addressed in the patient’s transition from inpatient to outpatient.

    While the study demonstrated the value of EHR use in improving anticoagulant therapy between outpatient and inpatient settings and across providers, the study was limited to one health care system’s experience.

    In a user-satisfaction survey conducted after the study, 61 percent of providers reported that the new warfarin order form was “user-friendly and accessible,” according to the study.

    Additionally, a majority of respondents stated the order form improves warfarin management through “inclusion of pertinent management data” as well as “clear expectation of warfarin management team and supervising physician discharge.”

    Ultimately, the study encourages EHR use in warfarin management expands across providers and regions to reduce errors in outpatient monitoring. 

    Dig Deeper: 
    Reducing Medical Errors with Improved Communication, EHR Use
    How EHR Technology Definitions Influence EHR Use Statistics 

    X

    EHRIntelligence

    Sign up to continue reading and gain Free Access to all our resources.

    Sign up for our free newsletter and join 60,000 of
    your peers to stay up to date with tips and advice on:

    EHR Optimization
    EHR Interoperability
    EHR Replacement

    White Papers, Webcasts, Featured Articles and Exclusive Interviews

    Our privacy policy

    no, thanks

    Continue to site...