Using IT to Improve Medication Safety for Rural Elders

利用信息技术提高农村老年人用药安全

• 批准号: 6951027
• 负责人: PAUL N GORMAN
• 金额: $ 44.34万
• 依托单位: NORTH LINCOLN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2007-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6951027
• 关键词: automated medical record system; clinical research; computer program /software; computer system design /evaluation; cooperative study; extended care; frail elderly; health care facility information system; health services research tag; human old age (65+); human subject; patient safety /medical error; rural area; rural health

DESCRIPTION (provided by the applicant): A major barrier to realizing the benefits of health information technology is "stovepiping" of clinical data in incompatible systems, creating what McDonald has called "islands of data." Availability of complete, accurate clinical data is especially critical for medication information relating to frail, chronically ill elders in Assisted Living (AL) and Skilled Nursing Facilities (SNFs), who are at greater risk for medication-related problems because of advanced age, frailty, high-risk medications, and multiple care providers. "Yet physician groups, hospitals, and other health care organizations operate as silos, often providing care without the benefit of complete information about the patient's condition, medical history, services provided in other settings, or medications prescribed by other clinicians" (IOM, 2003). To address this problem, we propose to implement and evaluate a Patient-Centered Medication Information System (PCMIS) to improve the health of frail, chronically ill elders in rural Oregon. The aims are to: 1) Provide secure access to accurate, complete, and current medication information for patients, clinicians, pharmacists, and nurses who prescribe, dispense, or administer medications; 2) Reconcile differences in medication information in separate, often discordant information systems of clinics, pharmacies, and residential care facilities; 3) Reduce medication errors and adverse effects by eliminating interactions, duplications, and inappropriate medications; 4) Provide a platform for evidence-based decision support and public health monitoring to improve the quality and efficiency of care; 5) Assess benefits and costs of the system through robust evaluation; and 6) Extend this information integration model statewide and beyond via the Oregon Rural Practice Based Research Network (ORPRN).This project is the work of a consortium of (a) rural providers and community organizations with a record of collaboration to implement technology; (b) organizational support of ORPRN; and (c) scientific expertise of University faculty in computer science, informatics, medicine, nursing, pharmacy, and epidemiology.

描述（由申请人提供）：实现健康信息技术的好处的一个主要障碍是在不兼容的系统中“排放”临床数据，从而形成麦克唐纳所说的“数据孤岛”。提供完整、准确的临床数据对于生活辅助 (AL) 和专业护理机构 (SNF) 中体弱、慢性病老年人的用药信息尤其重要，这些老年人由于高龄、体弱，出现药物相关问题的风险更大、高风险药物和多个护理提供者。 “然而，医生团体、医院和其他医疗保健组织各自为政，通常在提供护理时无法获得有关患者病情、病史、其他环境中提供的服务或其他临床医生处方药物的完整信息”（IOM，2003 年） ）。为了解决这个问题，我们建议实施和评估以患者为中心的用药信息系统 (PCMIS)，以改善俄勒冈州农村地区体弱、患有慢性病的老年人的健康。其目标是： 1) 为开药、配药或管理药物的患者、临床医生、药剂师和护士提供准确、完整和最新的药物信息的安全访问； 2) 协调诊所、药房和住宿护理机构各自独立、通常不一致的信息系统中药物信息的差异； 3）通过消除相互作用、重复和不适当的用药来减少用药错误和不良反应； 4）提供循证决策支持和公共卫生监测平台，以提高护理质量和效率； 5）通过稳健的评估来评估系统的效益和成本； 6) 通过俄勒冈州基于农村实践的研究网络 (ORPRN) 将这一信息集成模型扩展到全州及其他地区。该项目是 (a) 具有实施技术合作记录的农村提供者和社区组织的联盟的工作； (b) ORPRN 的组织支持； (c) 大学教师在计算机科学、信息学、医学、护理、药学和流行病学方面的科学专业知识。