The Development and Piloting of the Ambulatory Electronic Health Record Evaluation Tool: Lessons Learned.

摘要: Background Substantial research has been performed about the impact of computerized physician order entry on medication safety in inpatient setting; however, relatively little done ambulatory care, where most medications are prescribed. Objective To outline development and piloting process Ambulatory Electronic Health Record (EHR) Evaluation Tool to report quantitative qualitative results from pilot. Methods The EHR closely mirrors version tool, which is administered by The Leapfrog Group. tool was piloted with seven clinics United States, each using a different EHR. consists test reconciliation module. For test, entered patients associated orders into their recorded any decision support they received. An overall percentage score unsafe detected, category scores were provided clinics. module, demonstrated how electronically detected discrepancies between two lists. Results For correctly alerted 54.6% orders. Clinics scored highest drug allergy (100%) drug–drug interaction (89.3%) categories. Lower scoring categories included age (39.3%) therapeutic duplication (39.3%). None for laboratory or monitoring In three (42.8%) had an EHR-based function; only one those could demonstrate it during Conclusion Clinics struggled areas advanced such as age, laboratory, drub monitoring. Most did not have function this dependent accessing patients' Wider use improve outpatient can inform vendors improvement.