Electronic medical records
A large group practice operates an electronic health record system that is closely integrated with a personal health record system that gives patients (and authorized caregivers as proxy users) secure access to key components of their medical records and the ability to request appointments, renew prescriptions, and communicate with physicians electronically. The integrated system has generated high levels of satisfaction among patients and caregivers, who report increased involvement in their health care, and physicians who report being able to practice more efficiently.
An electronic medical record–based system features “soft” and “hard” stop functions designed to ensure that clinicians perform medication reconciliation, leading to a rapid, significant, and sustained increase in adherence rates.
Nurses at Aultman Hospital assess patients preoperatively for risk of pressure ulcers, carefully monitor and address risk factors during surgery, and complete a communication tool to inform postoperative surgical care; the program led to the elimination of Stage 3 and 4 pressure ulcers hospital-wide and very low incidence of Stage 1 and 2 pressure ulcers in surgical patients.
A medical complex houses a primary care practice, a wide array of specialty practices, and ancillary service providers who operate independently but collaborate closely to provide same-day access and communicate in real time on individual cases, leading to improvements in breast and colon cancer screening rates and to higher physician and patient satisfaction.
Popup, color-coded alerts within an electronic health record moderately improve adherence to established guidelines in primary care practices serving pediatric patients with asthma.
Trained, bilingual medical assistants in a capitated health center serve as health coaches to chronically ill (often diabetic) patients of similar ethnic or racial backgrounds, leading to better disease management and clinical outcomes for those with diabetes, very positive feedback from patients and center staff, and low turnover among medical assistants and coaches.
Clinic providers compare patients' self-reported medication lists (generated through an easy-to-use automated system featuring a computer kiosk and simple touchscreen interface) to medications listed in the electronic medical record, allowing them to adhere more closely to established medication reconciliation practices and to identify and address more medication discrepancies, including potentially lethal ones.
A low-overhead medical home leverages information technology to produce a financially viable, high-quality primary care experience that proves to be attractive to both physicians and patients in an underserved rural area.
Real-time, resident-specific medication information and alerts, with support from a medication safety team, enhanced the efficiency of medication administration and reduce medication errors.
As part of a statewide, public-private initiative, a largely rural Vermont community supports its six medical patient-centered medical home practices with a multidisciplinary provider team, real-time electronic information, and insurer-funded financial incentives, leading to more appropriate care and services and lower utilization and growth in health care spending.