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An EMR-Powered DM Program with Strong "Heart"

September 16, 2009
by Mark Hagland
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It was very heartening to read the announcement by Kaiser Permanente last month regarding Kaiser Colorado’s coronary artery disease (CAD) program, a disease management program that has been truly EMR-powered. For the first time, a randomized clinical study has documented a dramatic improvement in cardiac mortality rates with an EMR-supported DM program. What happened?

According to Kaiser-Colorado officials, the use of an EMR to help keep CAD patients connected to teams of pharmacists, nurses, primary care physicians, and cardiologists, helped cut cardiac deaths by an astounding 73 percent, and kept patients healthy two years after they’d left the DM program, by keeping them connected electronically with their providers, as revealed in a study published last month in The American Journal of Managed Care. The study, funded by the AmericanCollege of Clinical Pharmacy, is the first randomized study to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction services, according to the study’s researchers. The two-year randomized trial of 421 patients found that patients discharged from the program kept their lipid and blood pressure levels at controlled, healthy levels, through the use of electronic reminder letters as prompts to the patients.

“Because lack of adherence to medications and failure to maintain treatment goals are so high among heart disease patients, we wanted to find out what would happen to the patients after they were discharged from the program but remained in contact with the healthcare system through our electronic health record,” Kari L. Olson, a clinical pharmacy specialist with Kaiser Permanente Colorado’s Cardiac Risk Reduction Program, said, in the organization’s press release.

What Olson and her colleagues found was that electronic communication between and among patients and all their clinical caregivers really makes a difference, something that DM leaders have long known, but have until recently not documented widely in clinical studies in the literature. The clinical results were terrific, including not only that marquee statistic of a 73 percent reduction in cardiac mortality; but also, a jump from 26 percent to 73 percent, of patients in the program meeting their cholesterol goal; and a leap from 55 percent to 97 percent of patients screened for cholesterol in the first place.

I’m always strongly heartened (pun slightly intended!) to hear of yet another case study that documents the tremendous gains made when clinical IT is used intelligently to support meaningful patient care innovation. And though this particular initiative took place within the closed-panel Kaiser system, its results should easily be replicable elsewhere in healthcare. The takeaway? Really smart use of IT to support smart patient care improvement makes for fantastic results.

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Mark Hagland

Editor-In-Chief

Mark Hagland

@hci_markhagland

www.healthcare-informatics.com/blog/mark-hagland

Mark Hagland became Editor-in-Chief of Healthcare Informatics in January 2010. Prior to that, he...