AI improves medication management and helps healthcare providers at Emory Healthcare
It may seem obvious that patients’ medication information should be accessible to their doctors, but that is not always the case. While technology has made it possible for hospitals to collect a mountain of patient data, hospitals can work to make that information more readily available to doctors at the time of treatment.
THE PROBLEM
“Sharing high-quality data across our healthcare system is more than a matter of efficiency: it is also vital to our Epic EHR’s ability to activate critical safety controls such as drug interactions and allergy alerts that can help reduce drug side effects ,” said Dr. Alistair Erskine, chief information and digital officer at Emory Healthcare. “Access to medication information documented during every encounter with our healthcare system allows physicians to make evidence-based decisions and provide the best possible patient care.
“For many patients, especially those with chronic conditions, taking medications as prescribed is essential for positive health outcomes and staying out of the hospital, while noncompliance can lead to a worsening of diseases and conditions and increased healthcare costs,” says he. continued. “Unfortunately, several barriers can prevent patients from adhering to their drug therapies, and the healthcare team often has no way of knowing when medications are not being taken as prescribed.”
Emory Healthcare is committed to developing strong relationships with patients beyond the physical boundaries of the hospital. By improving the prescribing and management of medications – from visiting the doctor to picking up a prescription at the pharmacy – it can help patients access and adhere to affordable, appropriate prescription medications for their health problems and ailments, Erskine added.
“This is critical to the health of individual patients and vital to public health initiatives that require healthcare providers to identify patients who may need help staying on track with their medication therapy and intervene early to prevent negative outcomes and prevent them from keep the hospital,” he says. he said.
PROPOSAL
Emory imported medication history data into its Epic EHR via an industry-standard feed. When information was missing, doctors filled in the gaps by calling pharmacies to collect and confirm a patient’s medication list, then manually entering that information, which is time-consuming and increases the potential for human error.
Failure by the healthcare organization to have a comprehensive history of filling prescriptions can delay medication reconciliation and hinder the ability to track medication adherence for public health programs that support high-risk patients.
“To address the interconnected challenges of reduced staff productivity and patient safety risks arising from a lack of access to accurate and actionable medication history, we turned to three medication management services offered within Fuzion by DrFirst, a software platform that uses clinical AI to streamline clinical workflows,” explains Erskine.
The three services he described include:
- Medication history with clinical-grade AI, which provides more information than the standard feed and reduces the need for manual data entry in Epic workflows.
- Prescription pricing transparency, allowing providers to see patients’ pharmacy benefits, including their out-of-pocket costs, before they leave the doctor’s office or hospital.
- Automated messaging, involving patients when their doctors send electronic prescriptions to their pharmacy.
MEETING THE CHALLENGE
Previously at Emory, when patient medication data was imported into the Epic EHR, prescription instructions or SIGs often arrived as unstructured free text, often with missing pieces of information and using a variety of terms for the same instructions (for example, “by mouth” versus “ oral”).
The new medication history system uses a clinical-grade AI engine to automatically convert that data into the EHR, giving physicians at the point of care more complete data and saving pharmacists time reconciling medications.
By deciphering clinical language, interpreting missing clinical details, and standardizing with preferred terminology in the appropriate fields in the patient record, the AI engine ensures that a patient’s list of medications matches what the patient is actually taking.
“For example, if a prescription for a Lisinopril 10 mg tablet contains the instruction ‘tk 1xD’, the AI interprets the clinical intent, but also sees that a route of ‘oral’ can be safely inferred for this drug,” Erskine explained. “Because it is integrated into our proprietary Epic workflow, the system reduces the burden on our physicians by delivering more information and requiring less manual data entry.
“Now that we have access to this medication history data, we can also track the fill rates of these patients, identify gaps in medication adherence, and identify those who may be at risk for readmission,” he continued.
The technology also provides Emory prescribers with patient-specific drug cost information while interacting face-to-face with patients.
“As prescription drug prices continue to rise, our patients need the opportunity to discuss options with their physicians during office visits,” Erskine noted. “Knowing these costs up front allows physicians to have meaningful conversations with patients about options for a more affordable therapeutic equivalent and better understand what patients can expect to pay before they arrive at the pharmacy.
“We hope to help minimize the financial barriers that prevent patients from filling their prescriptions by reducing the frequency of prescription abandonment due to ‘sticker shock,’ which can also help address adherence issues in our most vulnerable patient populations,” he continued.
Another way Emory engages patients in their care is through automated text messages that provide relevant educational information with financial savings, plus reminders to pick up their prescriptions. The HIPAA compliant functionality allows patients to view their prescription and pharmacy information, as well as receive educational information and financial savings for their medications.
“Patients can choose to receive Emory prescription notifications or opt out of receiving text message alerts,” he said. “For prescribers, the functionality is embedded in the e-prescribing workflow in our Epic EHR, so no additional steps are required.”
RESULTS
Emory went live with its medication history and price transparency systems in October 2023, followed by its patient engagement messaging system in mid-November.
“In the first month, our physicians collected more medication history data from more patients with fewer clicks and keystrokes,” Erskine reported. “The actual figures vary per hospital location, but the first results show this
“The AI improves medication history data for 81% of all available home medications, so our patient records have fewer gaps,” he continued. “We also collect medication history data from 92% of our patient population ages 65 and older, which supports our medication reconciliation initiatives regarding high-risk patients.”
ADVICE FOR OTHERS
Emory Healthcare believes that positive employee experiences drive positive patient experiences. By bringing together the right technologies with the right people, it aims to take the human component of healthcare processes to the next level, using tools like AI to give doctors the time and information they need to do what they do best are: taking care of patients, Erskine said. .
“Health systems looking to implement AI into clinical workflows must assess where it can be most effective in reducing manual processes, reducing administrative burdens and empowering physicians to deliver the best possible care,” he continued . “Medication management is an area that offers opportunities for improvement by using intelligent automation to improve the quality of patient data and the efficiency of workflows.”
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