Health Information Technology and Improving Mediciation Use

描述(由申请者提供)：国家正在对健康信息技术(HIT)进行巨额投资，相信HIT将成为使医疗保健开始跨越质量鸿沟的关键工具。大量研究现在证明，在特定的最佳情况下，这种HIT可以用来显著提高处方的安全性和质量，同时降低其成本。因此，治疗学和HIT之间的交叉代表着一个核心驱动因素，即这个国家是否真的收到了预期从其HIT投资中获得的价值。不幸的是，结果仍然不确定。具体前沿包括如何进行更有效的上市后监测，如何使用决策支持来改善慢性病管理中的治疗方法，如何确保HIT干预措施导致的新错误数量最少，如何平稳过渡，临床数据交换的开始将如何影响等式，以及哪些决策支持可以广泛实施。在这份提案中，我们描述了以下六个解决这些问题的项目，以及申请申请中的所有关键优先事项。 1)使用电话询问从电子健康记录(EHR)数据获知已开出特定药物的门诊患者的影响评估，无论他们是否正在经历与这些药物相关的特定不良反应。 2)评估门诊护理中临床决策支持和自动电话联系对降压和降脂治疗的影响。 3)对电子处方实施过程中产生的新错误进行定性评价。 4)对实施出院后非卧床用药协调干预的影响进行评估。 5)在纽约对6个区域卫生信息组织对其用药安全性的影响进行评估。 6)开发AMIA由ONCHIT赞助的临床决策支持路线图，确定一套可在多种环境中使用的临床决策支持规则。 这些结果应该有助于评估当前与HIT相关的干预措施如何能够广泛推广，并开辟新的领域。此外，我们将建立和支持教育工具和项目，以帮助治疗学和HIT。

DESCRIPTION (Provided by Applicant): The country is making huge investments in health Information technology (HIT), with the belief that HIT will be a key tool to enable healthcare to begin to cross the quality chasm. Substantial research now demonstrates that in specific best-case situations, that HIT can be used to dramatically improve the safety and quality of prescribing, while reducing its costs. As a result, the intersection between therapeutics and HIT represents be a central driver of whether or not the nation actually receives the value expected to accrue from its HIT investment. Unfortunately, the outcome remains uncertain. Specific frontiers include how to do more effective post-marketing surveillance, how to use decision support to improve therapeutics in chronic disease management, how to ensure that HIT interventions cause a minimal number of new errors, how to smooth transitions for patients, how the onset of clinical data exchange will affect the equation, and what decision support can be broadly implemented. In this proposal, we describe the following six projects, which address these issues, and all the key priorities in the request for applications. 1) An evaluation of the impact of using telephony to ask outpatients known from the electronic health record (EHR) data to have been prescribed specific medications whether or not they are experiencing specific adverse effects related to those medications. 2) Evaluation of the impact of clinical decision support and automated telephone outreach on antihypertensive and lipid-lowering therapy in ambulatory care. 3) Qualitative evaluation of new errors created when electronic prescribing is implemented. 4) Evaluation of the impact of implementation of a post-discharge ambulatory medication reconciliation intervention. 5) Evaluation in New York among 6 Regional Health Information Organizations of their effects on medication safety. 6) Development of AMIA's ONCHIT-sponsored Clinical Decision Support Roadmap with identification of a set of clinical decision support rules which can be used in multiple settings. These results should both help in assessing how current HIT-related interventions can be rolled out broadly, and also break new ground. In addition, we will build and bolster educational tools and programs to assist with therapeutics and HIT.