Electronic Health Record Links Care Givers And Cardiac Patients

Electronic health records of patients helped them stay healthy even two years after they left the program by keeping them in touch with their care givers electronically, according to a study.

The program at Kaiser Permanente, which reduced cardiac deaths by 73 percent, linked coronary artery disease patients and teams of pharmacists, nurses, primary care doctors, and cardiologists via the electronic health record system.

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The researchers said that the study was the first randomised study to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction service.

The Clinical Pharmacy Cardiac Risk Service at Kaiser Permanente Colorado combines Kaiser Permanente's industry-leading electronic health record, Kaiser Permanente HealthConnect, with proactive patient outreach, education, lifestyle adjustments, and effective medication management.

The two-year randomised trial of 421 patients found that patients discharged from the program kept their lipid and blood pressure levels at controlled, healthy levels by receiving electronic reminder letters.

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"Because lack of adherence to medications and failure to maintain treatment goals are so high among heart disease patients, we wanted to find out what would happen to the patients after they were discharged from the program but remained in contact with the health care system through our electronic health record," said the study's lead author, Kari L. Olson.

He added: "The takeaway message here is that we can help support patients in maintaining treatment goals and medication adherence, which is often a challenge with most chronic conditions. Using technology and integrated systems already in place, we can help keep patients healthy for longer and deliver continuity of care in a cost efficient manner."

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For the study, 421 patients in the program with well-controlled blood pressure and cholesterol levels were randomised so that 214 continued in the program to receive intensive direct counseling from the care team.

The other 207 patients were discharged from the program back to their primary care physician.

The patients who were discharged from the program had electronic reminders in their chart to ensure their lipid panels were ordered annually, with the results sent directly to their primary care physician.

The discharged patients also received reminder letters generated by KP HealthConnect, indicating they were due for a lab test.

The most important finding of the study was that the patients discharged from the program maintained control of their risk factors with the help of electronic reminder letters.

The EHR intervention was as effective at keeping cholesterol and blood pressure in check, compared to the more intensive counseling approach offered to those patients who stayed enrolled in the program.

After going through the program, the patients were found to have an 88 percent reduced risk of dying of a cardiac-related cause when enrolled within 90 days of a heart attack, compared to those not in the program.

The number of patients meeting their cholesterol goal went from 26 percent to 73 percent, and the number of patients screened for cholesterol went from 55 percent to 97 percent.

The coordinated, evidence-based care, enabled by KP HealthConnect and an electronic care registry, increased the survival rate dramatically among patients enrolled in the service.

It is estimated that more than 135 deaths and 260 costly emergency interventions were prevented annually as a result of improved care.

The study has been published in The American Journal of Managed Care.

Source-ANI
ARU