To provide high-quality patient care, physicians and other clinicians need quick and easy access to patient records. However, many health systems struggle to provide comprehensive information in a consistent format precisely when it is needed most – at the point of care.
PROBLEM
Baptist Health, serving the community of Jacksonville, Florida, through an extensive health care network that includes six hospitals and more than 200 specialists and primary care facilities, like many others in their area. is using various electronic health record systems for its hospitals, emergency clinics, and other care facilities.
Unfortunately, these different systems did not communicate with each other.
Therefore, clinicians cannot view a patient’s complete medication history. Clinicians rely on the patient as the source of truth, which requires them to manually enter data into the local EHR each time a patient visits another Baptist Health facility. The drug matching process is not only inefficient but also prone to errors.
“To address these issues and ensure we provide clinicians with powerful data to make the best care decisions, our health system aims to goal of eliminating disparate systems and consolidating patient data in a single, enterprise-wide Epic EHR”. Johnston, vice president, director of applications, and executive director of Epic programs at Baptist Health.
The goals for the project include:
- Improve patient care by seamlessly sharing health information across all practice locations.
- Improve operational efficiency by spending less time copying medication data, making phone calls, or tracking individual patient medication details.
- Improve evidence-based decision-making as an organization by providing all data points in one platform. Without this, large-scale data analysis would be extremely difficult, as the reporting structure is not the same across EHR platforms.
PROPOSE
“We planned to deploy Epic to five existing and one new hospital, three independent emergency departments, our outpatient cancer clinic, and more than 200 points of care,” explains Johnston. “As part of the project, we needed to consolidate millions of drugs, clean up prescription guides (called “sigs”), and ensure free text was entered into separate fields in the new EHR. After researching a few providers, we chose DrFirst’s MedHx because its AI normalizes the data for us.
“MedHx provides six months of drug data from pharmacy benefit managers, EHRs, pharmacy fill data, and payer records,” she continued. “Its artificial intelligence uses clinical and statistical context to clean and structure medication history data, to prevent missing information, while avoiding manual entry.”
“By consolidating EHR and adding an AI-powered medication history solution, we can better care for our patients, while giving clinicians powerful data at their fingertips. for them to make the best care decisions.”
Dr. Stacey Johnston, Baptist Health
It normalizes sig information into consistent terms, translates national drug codes between different databases, securely infers missing information, and processes free text so that it pre-populates separate school. It also allows staff to migrate continuity of care documents from legacy EHR systems to Epic.
“The AI-powered medication history solution improves the quantity and quality of drug information available directly in clinical workflows to enable efficient drug matching,” notes Johnston. “It’s important when patients arrive in the emergency department who are unable to communicate and is essential to prevent inaccuracies reported by patients and families.
“It can also help streamline admission and discharge processes and avoid medication adjustment errors during transitions,” she added.
MEET CHALLENGES ONLY
Baptist Health’s clinical applications team has worked with multiple stakeholders across the organization to audit, authenticate, and ensure physicians and other clinicians can access unified drug data in real time.
“Beginning early 2020 and continuing until our official project kicks off in October 2020, we’ve worked with over 170 clinic partners running a variety of EHR platforms , to demonstrate the benefits of consolidation and obtain their consent,” Johnston recalled. “Next, we worked with inpatient units to understand and document legacy workflows for medication history and drug reconciliation so we could ensure EHR profiles new will fit workflows for all areas of practice.
“We then worked closely with Epic and DrFirst to build, deploy, and test the new EHR system and medication history tools in partnership with our executive team,” she said. he continued. “Following the rollout, we rolled out a new medication history tool and process training program, and made sure the right people had secure access.”
RESULT
When a drug record is entered into the EHR system, the sign appears as unstructured free text, often missing pieces of information, and using multiple terms for the same instruction (e.g. “oral” ” versus “oral”).
MedHx uses AI to decode clinical language and interpret missing clinical details that are implied but not present.
“Consider the prescription for a 10mg Lisinopril (a medication for high blood pressure), which includes a ‘tk 1xD’ instruction,” explains Johnston. “The AI not only interpreted the clinical intent, but found that for this drug, a safe ‘drink’ route can be inferred.
“Since our Epic launch on July 30, 2022, our health system has converted more than 7,352,000 sigs of drugs without clinician intervention using MedHx,” she said. continue. “A subset of these conversions has no sig provided in third-party data, and the sig is inferred by technology.”
Another subset had sigs available, but only in free text, and Epic converted them to sigs that were specifically defined in the database. Prior to merging EHR and MedHx integration, clinicians would be responsible for manually converting all 7,352,000 sigs. By avoiding this conversion, Baptist Health has saved clinicians significant time and reduced the potential for transcription errors.
“We also identified more than 3,000 additional high-risk drugs from more than 1,700 unique patient drug records that were not identified by older EHR systems,” said Johnston. “Awareness about these drugs helps improve patient safety and informs our clinicians to better prescribe and manage medications.
“We also enable our medication history technicians to conduct consultations remotely and efficiently perform medication histories,” she added.
TIPS FOR OTHER PEOPLE
“Sharing high-quality data across your healthcare system is critical to your EHR’s ability to trigger critical safety checks, such as drug interactions and allergy alerts, that can can help reduce the side effects of the drug,” says Johnston. Seamless data sharing also allows your clinicians to access all of the drug information recorded during any encounter with your health system so they can bring Make evidence-based decisions and provide the best possible patient care.
“By consolidating EHR and adding an AI-powered medication history solution, we can better care for our patients, while providing clinicians with powerful data right at our fingertips. hands for them to make the best care decisions,” she continued.
Another key goal is to provide patients with access to their health information and medication records from any web browser – not only from Baptist Health but also from other health systems running with it. EHR.
“This will be increasingly important in the future as new regulations ensure patients’ rights to their medical records,” she concluded.
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: [email protected]
Healthcare IT News is a publication of HIMSS Media.
