An effort to improve electronic health record medication list accuracy between visits: Patients' and physicians' response
An effort to improve electronic health record medication list accuracy between visits: Patients' and physicians' response
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DOI：
10.1016/j.ijmedinf.2007.03.001
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发表时间：
2008-03-01
影响因子：
4.9
通讯作者：
Bates, David W.
中科院分区：
文献类型：
--
作者：
Staroselsky, Maria;Volk, Lynn A.;Bates, David W.
目的：评估一种安全的基于网络的患者门户网站，即患者网关（PG）在电子健康记录（EHR）中生成更准确的药物清单方面的功效，以及向初级保健医生（pcp）发送更新其患者提供的信息的临床信息是否会导致医生更新EHR药物清单。方法：对84例使用PG的患者与79例未使用PG的患者的用药清单准确性进行比较。研究人员在EHR的临床记录中记录了患者报告的药物差异，并向参与者的pcp发送了一条消息，通知他们更新的信息。结果：根据EHR，参与者服用了665种药物，并报告了273种额外的药物。PG使用者的药物方案的正确率（54%对61%，p = 0.07）比不使用PG的人低，尽管PG使用者比不使用PG的人服用更多的药物（5.0对3.1种药物，p = 0.0001）。在临床记录中提供患者报告的信息，并向初级保健医生发送临床信息，并没有导致pcp更新患者的电子病历药物清单。结论：电子病历中的药物清单经常不准确，最常被忽视的是非处方药（OTC）和非处方药。使用安全门户的患者在药物清单和自我报告之间的差异与不使用安全门户的患者一样多，并且通过电子邮件通知医生存在差异没有效果。2007爱思唯尔爱尔兰有限公司版权所有。
Objective: To evaluate the efficacy of a secure web-based patient portal called Patient Gateway (PG) in producing more accurate medication lists in the electronic health record (EHR), and whether sending primary care physicians (PCPs) a clinical message updating them on the information their patients provided caused physicians to update the EHR medication list.Methods: We compared the medication list accuracy of 84 patients using PG with that of 79 who were not. Patient-reported medication discrepancies were noted in the EHR in a clinical note by research staff and a message was sent to the participants' PCPs notifying them of the updated information.Results: Participants were taking 665 medications according to the EHR, and reported 273 additional medications. A lower percentage of PG users' drug regimens (54% versus 61%, p = 0.07) were reported to be, correct than those of PG non-users, although PG users took significantly more medications than their non-user counterparts (5.0 versus 3.1 medications, p = 0.0001). Providing patient-reported information in a clinical note and sending a clinical message to the primary care doctor did not result in PCPs updating their patients' EHR medication lists.Conclusions: Medication lists in EHRs were frequently inaccurate and most frequently overlooked over-the-counter (OTC) and non-prescription drugs. Patients using a secure portal had just as many discrepancies between medication lists and self-report as those who did not, and notifying physicians of discrepancies via e-mail had no effect. (C) 2007 Elsevier Ireland Ltd. All rights reserved.