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Electronic Medical Record (EMR) Tool for Hospitalized Patients to Facilitate Safe Management of Pulmonary Arterial Hypertension Patients on Prostacyclin Therapy

T Driscoll

Michael Duncan

April Blakley

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Conference: 2018 PHA International PH Conference & Scientific Sessions

Release Date: 06.28.2018

Presentation Type: Abstracts

File Download: Conference 2018_1022

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2018 International PH Conference and Scientific SeAbstract presented at the 2018 International PH Conference and Scientific Sessions in Orlando, Fla., June 28-July 1, 2018.

Background

Prostacyclin therapy, specifically epoprostenol, has been identified by the Institute for Safe Medication Practices (ISMP) as high alert medication in the acute care setting.1 In a survey of pulmonary hypertension (PH) health care providers, 68-94% reported serious errors occurred with these medications.2 The purpose of this Electronic Medical Record (EMR) tool was to develop and implement a tool for hospitalized patients to facilitate safe management of pulmonary arterial hypertension (PAH) patients on prostacyclin therapy. This tool was developed to alert PAH providers of patients admitted on prostacyclin therapy to decrease medication errors, enhance communication in the health system, and facilitate transitions of care.

Methods

A tool was developed to query the EMR database for patients hospitalized with active orders for prostacyclin therapy (epoprostenol and treprostinil, all dosage forms) in a single tertiary/quaternary 800 bed hospital within a large, state-wide hospital system. When a new medication order for prostacyclin therapy is ordered inpatient, a secure message is sent to notify the pulmonary hypertension team (PH physician, PH clinical nurse coordinator, and PH clinical pharmacist). The PH team then reviews the patient and therapy for appropriateness and accuracy to ensure continuity of care from the outpatient setting to the inpatient setting.

Results

Prior to implementation of this EMR tool, there was a lack of a systematic approach to notifying the PH team of patients on prostacyclin therapy when admitted to the hospital. From March 2017 to February 2018, six PAH patients on prostacyclin therapy were admitted inpatient without notification of the PH team. Since implementation of this EMR tool, the PH team has been successfully notified of PAH patients on prostacyclin therapy. This has enhanced inter-professional communication between inpatient specialty teams and outpatient specialty clinics to improve transitions of care and ensure patient safety.

Conclusions

This process improvement utilizing a newly developed EMR tool to identify hospitalized PAH patients on prostacyclin therapy resulted in increased communication with the PH team and improved safety for patients while ensuring continuity of care.