IT and Pharmacotherapeutics

Question 1

American Recovery and Reinvestment Act

Answer 1

DNP (Doctors of Nurse Practice) must be meaningful users of health information tools
Enacted to increase patient safety and reduce cost
Reimbursement connected to use of electronic health record (EHR), computerized provider order entry (CPOE), and clinical decision support systems (CDSS).
Changes in patient privacy

Question 2

EHR

Answer 2

Most practice areas can improve by using EHRs

Cost is a determinant for most practices: upfront and recoup

Goal: exchange of patient information between practice sites and hospitals and across regions

Question 3

Information Storage and Exchange

Answer 3

Vast amounts of patient data with EHRs
Data aggregation with clinical warehouse
EHR vs electronic medical record: difference in capability for repurposing data
Regional health information organizations allow for data sharing and exchange
Health information exchanges allow for added information sharing

Question 4

CPOE

Answer 4

Computerized Provider Order Entry
Embedded within the EHR for order entry
Increases safety by reducing the medication errors that occur with paper-based systems
Implementation and adoption slow in the US because of cost and changes in workflow
Based on the formulary of the organization

Question 5

CDSS

Answer 5

Clinical Decision Support Systems
CDSS alerts to guide the provider in decision making
Alerts require two patient data points from vital signs to laboratory data and medication history
CDSSs use elements of artificial intelligence and machine learning to function
Risk “alert fatigue” by having too many alerts for workflow

Question 6

Precision Health

Answer 6

Big data has reams of information
Can improve patient care and safety via analysis of specific patient characteristics to focus and personalize care
-Not just give one-size-fits-all therapies
-Genetics, lifestyle, and population inputs

Question 7

Medication Reconciliation

Answer 7

Required as part of meaningful use and to be done at each encounter
Technology using EHR and personal health record (PHR) can help meet this requirement
Reduces the risk of error with poor historians or when medications are not with the patient

Question 8

Patient Privacy

Answer 8

Health Insurance Portability and Accountability Act (HIPAA) standard for patient privacy
Now includes patient rights and privacy
Patients can have a copy of their records in electronic format

Question 9

PHR

Answer 9

Personal Health Record
Patient-owned and maintained health record
Commercial products available of a simple spreadsheet
PHRs can be connected to EHRs and include inpatient data
Encouraged to prevent health information being lost during national disasters

Question 10

Patient Education

Answer 10

Materials can be standardized and printed off the EHR or kept in electronic format
Electronic versions can also be edited for specific patient issues
Applications for smartphones can be recommended by providers for patient education
Internet with screening can be a good source of information

Question 11

Role as Clinical Leader in Quality Improvement (QI)

Answer 11

Serve as a provider of patient care and keep medication records in EHR
Assess practice for safety and quality with pharmacotherapeutics
Explore issues with medications as quality and safety issues