Using Health IT to Prevent Adverse Events - AHRQ National ...

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RecognizedMedication InSTEPSToolsKnowledgeBase(ie. Amoxicillin)STEPSToolsKnowledgeBaseQuerySTEPSToolsRecommendedRoundingPercentage*(ie. 15% forAmoxicillin)Calculate range above and below exactdose by rounding percentage.ie. 600 mg/dose * 1.15 = 690 mg/dose as high600 mg/dose * .85 = 510 mg/dose as low* Recommended percentages based on results from paneldiscussion of American Academy of Pediatrics and AmericanMedical Informatics Association experts
Formulationsof Medication*FormulationSpecific DoseRangesAmox 125 mg tab4.08 - 5.52 tabsAmox 250 mg/5ml liquidAmox 400 mg/5ml liquidWorkingRange(510 – 690mg/dose)10.2 – 13.8 ml6.375 - 8.625 mlPossibleDoseGenera<strong>to</strong>rCollectionofPossibleDoses*List of formulations for the medication areretrieved from a table in the STEPSToolsknowledge base which was derived from data inRxNorm.
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National Web-Based Teleconference o
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Meaningful Use Incentives
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Benefits of EHR data• symptoms, s
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Framework
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Target errors• Explicit voluntary
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Terminology challenges• Terminolo
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Deep Natural Language Processing“
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Demography of CXRs• 10 years; 889
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Falls• Calibrate database to lite
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Conflicts in the EHR
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Conflicts in the EHR: ―Digital cl
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Self reporting in the EHR
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Self reporting in the EHR• Accide
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Self reporting in the EHR: PPVMista
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Large scale event reporting
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Event reporting• Use NLP and 45 r
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Next-generation detection
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Data quality• All medical record
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Learning from the DataDeviation by
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345New Information ToolsGlucose0.45
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Conclusions
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Thank You!
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Medication Safety• The typical ho
Page 47 and 48:
MDMed OrdersOrderingErrors (49%)Tra
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Barcode/eMAR at the Bedside • Ord
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Real Time Alerts to Nurse
Page 53 and 54: Evaluating the Impact of Barcode-eM
Page 55 and 56: Impact on Potential Adverse Drug Ev
Page 57 and 58: Admin and Transcription Error Study
Page 59 and 60: Impact on Nurse Workflow• 232 2-h
Page 61 and 62: Implementation Factors• Software
Page 63 and 64: Implementation• 45 Enhancements t
Page 65 and 66: Information System Analyst• Troub
Page 67 and 68: Scanners•Need scanning flexibilit
Page 69 and 70: Bar Coding Inconsistencies• Where
Page 71 and 72: Physician Workflow• Inability toq
Page 73 and 74: Over Reliance• Technology driving
Page 75 and 76: Continued Feedback
Page 77 and 78: In Summary• Barcode technology si
Page 79 and 80: Kevin B. Johnson, MD, MSProfessor B
Page 81 and 82: • Adverse events are often mitiga
Page 83: • Single site study using interna
Page 87 and 88: Funded by AHRQ R 18 HSO17216
Page 89 and 90: • Mismatches between formulationr
Page 91 and 92: Goal - to improve the safety andusa
Page 93 and 94: • Discovered 115 medications to r
Page 95 and 96: • Many allow dosing in0.1 ml incr
Page 98 and 99: UsersE-PrescribingSystem ServerSTEP
Page 100 and 101: •Medication Name•Medication Enc
Page 102 and 103: For each known frequency…PatientW
Page 106 and 107: For each dose range…PossibleDoseG
Page 108 and 109: • If the age of the patient is le
Page 110 and 111: • Implementation in two vendor sy
Page 112 and 113: Thank You!
Page 114 and 115: Coming Soon!Our Next EventA webinar
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