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

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Identifying AEs using conflicts in EHR• Increase predictive value of AE detectionusing NLP• Find ―confl icts‖• e.g., mismatch between admit and discharge diagnoses• Design– 150 cases from each of 5 target areas– 2 internal medicine reviewersYu A, Stetson PD, Hripcsak G. Medinfo 2004:1923
Conflicts in the EHR: ―Digital clues‖Admittedfor DVT―hemor rhagicCVA‖DischargeDx:CVAtimeElevatedINRHeadCT:―midl ineshift‖ProtamineGiven
Page 1 and 2: National Web-Based Teleconference o
Page 3 and 4: Meaningful Use Incentives
Page 5 and 6: Benefits of EHR data• symptoms, s
Page 7 and 8: Framework
Page 9 and 10: Target errors• Explicit voluntary
Page 11 and 12: Terminology challenges• Terminolo
Page 13 and 14: Deep Natural Language Processing“
Page 15 and 16: Demography of CXRs• 10 years; 889
Page 17 and 18: Falls• Calibrate database to lite
Page 19: Conflicts in the EHR
Page 23 and 24: Self reporting in the EHR
Page 25 and 26: Self reporting in the EHR• Accide
Page 27 and 28: Self reporting in the EHR: PPVMista
Page 29 and 30: Large scale event reporting
Page 31 and 32: Event reporting• Use NLP and 45 r
Page 33 and 34: Next-generation detection
Page 35 and 36: Data quality• All medical record
Page 37 and 38: Learning from the DataDeviation by
Page 39 and 40: 345New Information ToolsGlucose0.45
Page 41 and 42: Conclusions
Page 43 and 44: Thank You!
Page 45 and 46: Medication Safety• The typical ho
Page 47 and 48: MDMed OrdersOrderingErrors (49%)Tra
Page 49 and 50: Barcode/eMAR at the Bedside • Ord
Page 51 and 52: 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
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Physician Workflow• Inability toq
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Over Reliance• Technology driving
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Continued Feedback
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In Summary• Barcode technology si
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Kevin B. Johnson, MD, MSProfessor B
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• Adverse events are often mitiga
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• Single site study using interna
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Funded by AHRQ R 18 HSO17216
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• Mismatches between formulationr
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Goal - to improve the safety andusa
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• Discovered 115 medications to r
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• Many allow dosing in0.1 ml incr
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UsersE-PrescribingSystem ServerSTEP
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•Medication Name•Medication Enc
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For each known frequency…PatientW
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RecognizedMedication InSTEPSToolsKn
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For each dose range…PossibleDoseG
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• If the age of the patient is le
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• Implementation in two vendor sy
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Thank You!
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Coming Soon!Our Next EventA webinar
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