– EHR alerts may be more effective in encouraging providers to prescribe preventive therapy than educating providers on the value of preventive therapies, according to a 2019 study by researchers at Penn Medicine.
Educating clinicians about the importance of prescribing certain therapies may not have a meaningful impact on patient care delivery, researchers determined.
The team tested interventions that used both peer education and EHR dashboards connected to patient health data to update doctors on which patients may benefit from preventive acid suppression therapy. Acid suppression therapy can be useful for reducing the risk of gastrointestinal bleeding in at-risk cardiac patients.
Ultimately, researchers determined education on acid suppression therapy does not make a significant impact on prescribing rates, while EHR alerts recommending preventive therapies contributed to an 18 percent increase in prescribing rates.
“This study shows that education alone is typically not a sufficient method for changing the behavior of providers and care teams,” said Shivan Mehta, MD, associate chief innovation officer and an assistant professor of medicine at Penn. “We demonstrated that although clinical leaders should collaborate to identify best practices, care redesign, technology, and behavior change strategies are also needed.”
Acid suppression therapy helps to reduce heartburn symptoms and treat ulcers through the use of medications that cut down on the level of acid in patients’ stomachs.
“The main reason the patients are at risk is because they’re placed on medications — or combinations of medications—such as anti-platelet agents or anticoagulation,” said Carolyn Newberry, MD, a former Penn Medicine Gastroenterology fellow and assistant professor of Medicine in Gastroenterology and Hepatology at Weill Cornell Medicine. “These medications are important for treating or preventing cardiovascular disease but they also have side effects such as increased bleeding in the G.I. tract.”
Prior to launching the EHR-integrated dashboard, prescription rates for cardiac patients who may benefit from acid suppression therapy at the health system was less than 73 percent. After launching the EHR alerts, prescription rates jumped to more than 86 percent for patients in the health system’s Cardiac Intensive Care Unit.
“No one dashboard or technology will work in every area, so it is important to partner with clinicians and identify workflows and processes where it can complement care,” Newberry said. “Our experience highlights this individualized nature and the importance of continued collaboration, along with process redesigns, to achieve sustainable success.”
EHR alerts have the potential to improve patient health outcomes in other areas of care by prompting healthcare providers to employ preventive therapies, researchers noted. Health IT developers at the Penn Medicine Center for Health Care Innovation are currently working to develop similar EHR dashboards and alerts for other specialties to increase the use of evidence-based practices.
Penn Medicine has made efforts in recent years to optimize EHR use to reduce administrative burden on providers and improve care quality.
In 2018, Penn Medicine launched a new initiative intended to transform EHR systems into more streamlined, interactive, and intuitive tools.
Penn Medicine leadership worked directly with clinicians to make EHR systems more user-friendly and address existing issues.
“We’re approaching this endeavor as if we were building a new clinical facility, laboratory, or training program: with a focus on the clinicians’ and patients’ needs,” said University of Pennsylvania Health System CEO Ralph W. Muller.
“Everything that shapes patient care should be designed to support the best possible outcomes. Electronic health records are a natural focus because they connect to everything we do,” Muller added.
Penn Medicine experts will work to ensure clinicians can view relevant, actionable patient health information in a timely manner.