Medication adherence is significant for sufferers, particularly when it comes to blood thinners prescribed after they leave the hospital. In specific, electronic health records (EHRs) have indicated value in assisting with anticoagulation therapy between outpatient and inpatient settings and across several providers.
That is the finding of a research from the institute of University of Missouri Health Care, which discovered that using EHRs can make better the care of patients on warfarin, usually prescribed blood thinners used to stop harmful clots, as well as eradicate potential confusion among providers and pharmacists.
Margaret Day, MD, a primary care physician and medical director at MU Health Care’s Family Medicine-Keene Clinic, asserts that the use of warfarin can be “potentially very complex and dangerous,” and that is borne out by the fact that adverse impacts of the drug accounts for 33% of annual emergency hospitalizations for patients 65 or older in the US.
In accordance to Day, the Joint Commission has called on healthcare organizations to decrease possible patient harm linked with the use of warfarin, a drug that needs frequent monitoring, daily dosing and can result in crucial negative effects when mixed with vitamin K, which is discovered in vegetables like lettuce or broccoli.
To ensure precise use of the blood thinners and medication for patients, MU Health Care designed an “outpatient warfarin management order” record in their Cerner EHR system that produces a comprehensive health summary for each admitted patient to make the procedure safer. Day says that her team discovered the discharge summary to be a precious tool to communicate 5 key elements required for patients and providers to handle the anticoagulation therapy.
She points out that physicians are prompted at patient discharge to enter 5 key elements when ordering warfarin management, like the reason a patient is taking the drug and what their aim is for the indication for anticoagulation, target International Normalized Ratio (INR).
“The data entered is visible to the patients and their community healthcare providers,” Day adds, asserting that it is significant to get the warfarin dosage just right. “In addition, the record also coordinates communication to pharmacy services for any dosage updates.”
Under the prior procedure, physicians would offer patients paper-based warfarin management plans, which made it complex for providers to later gain that information. Although, paper forms sometimes caused confusion among pharmacists, physicians and sufferers since the warfarin plans could change frequently.
Before executing the new record, Day and her team undertook a survey which disclosed that 42% of patients’ discharge charts involved key elements for discharging patients on warfarin. After the outpatient warfarin management order was executed in the EHR, that percentage almost doubled to 78%. Moreover, 61% of physicians and pharmacists surveyed who used the new warfarin order demonstrated that it was user friendly and accessible.
“We know that hospital transitions are potentially high-risk times for mistakes, specifically medicine mistakes for patients, and warfarin presents few special challenges due to the nature of the medicine,” she summarizes, adding that the outpatient warfarin management order fits right into the clinical workflow.
The new procedure not just gives notification about the transition care to sufferers’ referring providers in their communities, but also facilitates collaborative care with pharmacies, in accordance to Day.
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