informatics in primary care 2008

Design and implementation of a web-Design and implementation of a web-based patient portal linked to an electbased patient portal linked to an electronic health record designed to improronic health record designed to improve medication safety: the Patient Gateve medication safety: the Patient Gate

way medications moduleway medications module

Informatics in Primary Care 20Informatics in Primary Care 200808

OutlineOutline

IntroductionIntroduction Study settingStudy setting DiscussionDiscussion Long-term evaluation planLong-term evaluation plan ConclusionConclusion

IntroductionIntroduction The causes of ambulatory ADEs and undertreatThe causes of ambulatory ADEs and undertreat

mentment Medication discrepanciesMedication discrepancies Non-adherenceNon-adherence Inadequate monitoring and follow-upInadequate monitoring and follow-up

A Portal linked to an EHR has the potential A Portal linked to an EHR has the potential to to help address many medication safety anhelp address many medication safety and quality issuesd quality issues..

Study settingStudy setting

The type, duration and The type, duration and confidenceconfidence in the sympto in the symptom being related to that medication are elicited.m being related to that medication are elicited.

For physician viewFor physician view Medications Module fit into workflow.Medications Module fit into workflow. Concise overview of the information.Concise overview of the information.

Patient’s medication journal is displayed in Patient’s medication journal is displayed in medications screen.medications screen.

Medication Module also allows for verification Medication Module also allows for verification of allergy information.of allergy information.

Short-term evaluationShort-term evaluation

DiscussionDiscussion 20% of eligible patients consented to be in the st20% of eligible patients consented to be in the st

udy.udy. Users tended to be white and less impoverishedUsers tended to be white and less impoverished

Important lessonsImportant lessons Mix of free text, structured data fields within patient Mix of free text, structured data fields within patient

interface.interface. Integrating the application with clinicians’ workfloIntegrating the application with clinicians’ workflo

w.w. Document medication and allergy within one applicDocument medication and allergy within one applic

ation.ation.

Long-term evaluation planLong-term evaluation plan Studying the impact of the Medications Module oStudying the impact of the Medications Module o

n patient outcomes.n patient outcomes.

Clinical outcomes to be evaluated includeClinical outcomes to be evaluated include ADEsADEs Medication list accuracyMedication list accuracy Self-reported medication adherenceSelf-reported medication adherence

ConclusionConclusion Integration of this kind of intervention intIntegration of this kind of intervention int

o a patient portal represents o a patient portal represents a novel and pa novel and potentially powerful way to reduce ADEs anotentially powerful way to reduce ADEs and medication discrepancies.d medication discrepancies.