Many hospitalized patients are put on the drug warfarin to keep them from developing blood clots. However, warfarin can have serious side effects that affect a patient’s recovery, including severe bleeding problems and skin necrosis. So it’s important to closely monitor the use of the drug – and your hospital’s electronic health records (EHR) can help. 

According to a press release from the University of Missouri Health Care, the university’s hospital redesigned its EHR specifically to help coordinate care to improve patients’ warfarin management.

Better tracking

Past research suggests that up to 33% of emergency hospitalizations in patients age 65 and older each year are directly related to adverse effects of warfarin.

Because of how prevalent issues with warfarin use are, the Joint Commission has called on hospitals and other healthcare institutions to boost their efforts at preventing patient harm caused by the drug and other similar anticoagulants.

To tackle the problem, University of Missouri Health Care created an EHR entry called “Outpatient Warfarin Management Order.”

Using this order, providers were able to regularly track and update a patient’s recommended warfarin dosage directly through the EHR. Information would automatically appear on the patient’s discharge summary, and it could be electronically transmitted to pharmacists as well.

Before the hospital made the change, doctors just gave patients paperwork about their warfarin management plans. Not only did this make it harder to keep track of this data, it could also cause confusion at the pharmacy. Warfarin dosage can change frequently, so the printed plans often contained conflicting or out-of-date information.

However, electronic updates via the EHR could be made more frequently, meaning that patients and healthcare providers could be updated on changes as they’re made in real time.

Collaborative effort

Creating the special EHR entry made it much easier for doctors and pharmacists to keep track of patients’ warfarin use, both during the hospital stay and after discharge.

Before using the new EHR entry, University of Missouri Health Care reviewed patient records and found that only 42% of discharge summaries included necessary information for discharging patients who are taking warfarin.

After implementing the update, the number rose to 78%. In addition, out of all the doctors and pharmacists who participated in the initiative, 61% said the new warfarin order entry process was “user-friendly and accessible,” reducing the chance for errors that could harm patients after they leave the hospital.

Initiatives like this project will become more crucial as the feds push for better coordination of care across multiple healthcare settings, both inpatient and outpatient.

Hospitals that take the extra steps to provide patients’ regular care providers with comprehensive details about their health conditions and medications, including warfarin use, are setting themselves up for success in an era where payments are made based on quality and value.

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