Language
English
Publication Date
10-1-2023
Journal
Applied Clinical Informatics
DOI
10.1055/s-0043-1777107
PMID
38092360
PMCID
PMC10719043
PubMedCentral® Posted Date
12-13-2023
PubMedCentral® Full Text Version
Post-print
Abstract
Background: The purpose of the Ambulatory Electronic Health Record (EHR) Evaluation Tool is to provide outpatient clinics with an assessment that they can use to measure the ability of the EHR system to detect and prevent common prescriber errors. The tool consists of a medication safety test and a medication reconciliation module.
Objectives: The goal of this study was to perform a broad evaluation of outpatient medication-related decision support using the Ambulatory EHR Evaluation Tool.
Methods: We performed a cross-sectional study with 10 outpatient clinics using the Ambulatory EHR Evaluation Tool. For the medication safety test, clinics were provided test patients and associated medication test orders to enter in their EHR, where they recorded any advice or information they received. Once finished, clinics received an overall percentage score of unsafe orders detected and individual order category scores. For the medication reconciliation module, clinics were asked to electronically reconcile two medication lists, where modifications were made by adding and removing medications and changing the dosage of select medications.
Results: For the medication safety test, the mean overall score was 57%, with the highest score being 70%, and the lowest score being 40%. Clinics performed well in the drug allergy (100%), drug dose daily (85%), and inappropriate medication combinations (74%) order categories. Order categories with the lowest performance were drug laboratory (10%) and drug monitoring (3%). Most clinics (90%) scored a 0% in at least one order category. For the medication reconciliation module, only one clinic (10%) could reconcile medication lists electronically; however, there was no clinical decision support available that checked for drug interactions.
Conclusion: We evaluated a sample of ambulatory practices around their medication-related decision support and found that advanced capabilities within these systems have yet to be widely implemented. The tool was practical to use and identified substantial opportunities for improvement in outpatient medication safety.
Keywords
Humans, Electronic Health Records, Outpatients, Cross-Sectional Studies, Medication Reconciliation, Ambulatory Care Facilities
Published Open-Access
yes
Recommended Citation
Co, Zoe; Classen, David C; Cole, Jessica M; et al., "How Safe are Outpatient Electronic Health Records? An Evaluation of Medication-Related Decision Support using the Ambulatory Electronic Health Record Evaluation Tool" (2023). Faculty, Staff and Students Publications. 8472.
https://digitalcommons.library.tmc.edu/baylor_docs/8472