Health Information Technology and Improving Mediciation Use

描述（由申请人提供）：国家正在对医疗信息技术（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。大量研究现在表明，在特定的最佳情况下，HIT可用于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之间的交叉代表了一个国家是否真正从其HIT投资中获得预期价值的核心驱动因素。不幸的是，结果仍然不确定。具体的前沿包括如何做更有效的上市后监测，如何使用决策支持来改善慢性疾病管理中的治疗方法，如何确保HIT干预措施造成最小数量的新错误，如何为患者顺利过渡，临床数据交换的开始将如何影响方程，以及哪些决策支持可以广泛实施。在本提案中，我们描述了以下六个项目，它们解决了这些问题，以及申请请求中的所有关键优先事项。

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.