In the rapidly evolving landscape of healthcare, technology continues to play a pivotal role in enhancing patient care. Tools embedded into the electronic health record (EHR) stand out as easy to use, cutting-edge solutions designed to help clinicians optimize patient care. In the expanding field of precision medicine, software that leverages population pharmacokinetic (PK) models alongside patient-specific characteristics allows clinicians to conduct real-time PK/PD simulations at the point of care.
One important consideration when deciding on a precision dosing software is its ability to seamlessly connect directly with your electronic health record (EHR) - a sometimes overlooked yet indispensable element for unleashing the full potential and increased efficiency of Bayesian model informed precision dosing platforms.
EHR integration facilitates direct communication between the software and the EHR, enabling the automatic retrieval of data. Comprehensive patient information such as name, date of birth, sex, height, weight, MRN, encounter ID, and location are all critical items to consider for integration success. Additional details such as laboratory results and drug levels, as well as details regarding medication administration like dosage, infusion duration, and administered date/time, can also be seamlessly integrated.
The integration process provides several benefits, including:
1. Quicker patient evaluation
By automating the data import process, integration significantly reduces the need for manual input. In fact, a 2022 study conducted at Brigham & Women’s Hospital demonstrated that integration of a vancomycin precision dosing tool within the EHR could decrease the time dedicated to assessing pharmacokinetics by nearly 60%, saving ~3 minutes per patient intervention. As if the time savings weren't enough, integration can also nearly eliminate the risk of transcription errors seen with manual data entry.
There are multiple ways to establish this flow of patient and medication data between the EHR and an external application. In the ideal integration, data is transferred from the EHR directly to the application in real time, as soon as the application is opened and on demand by the user. However, this solution requires a more complex integration between systems, which normally requires some expertise from either the hospital system or the application vendor. In cases where this is not feasible, simpler solutions – such as a periodic automated transfer of data as a flat file –can be used. The use of a flat file means that the data found in the application is almost always incomplete and inaccurate due to its periodic nature, but it does provide some time savings in data entry.
It’s also important for a precision dosing platform to allow users to exercise their clinical judgment and manually correct any discrepancies (e.g. those entered inadvertently into the electronic medication administration record), ensuring accurate PK predictions.
2. Enhanced usability & additional features
Beyond its core functionalities, some EHR integrations offer additional features that enhance usability and versatility. The ability to directly access the dosing platform within the patient chart of the EHR brings an added layer of convenience and security by eliminating the need for separate login credentials or navigating to an external website. Customers are also able to easily document their PK interventions by creating and transferring summary notes directly into the EHR system with a single click.
By having a platform directly integrated, we are easily able to pull data and aggregate it into derived metrics to enhance performance. Location data, for example, can be pulled with integration, allowing clinicians to analyze their data at either the organizational level or by specific sites. When used alongside a companion analytics program, this feature enables better differentiation between hospital sites, thereby improving data representation.
3. Customizability & flexibility
With EHR integration, being able to customize where the application is located in the EHR and how it functions is important. Some clients opt to integrate the application seamlessly within dedicated sections of the patient chart, such as a section dedicated to antimicrobial stewardship or the Rx Navigator.
There are many other ways that the integration can be configured and be adapted to your needs, such as launching the application into pop-out windows or selectively including specific laboratory results. Adaptability ensures that organizations with differing workflows work with best-practices in mind, providing an optimized and efficient user experience tailored precisely to their needs.
Users should also have the flexibility to switch to a standalone, web-based workflow in the event of EHR downtime. Ideally, the standalone version would provide access to copies of patients' dashboards reflecting the most recent EHR update, with the option to manually update new doses, levels, and other information as needed.
4. Smooth implementation with ongoing support
What can be expected for the implementation of an application into an EHR system? The integration process involves a collaboration between a vendor’s technical team and the customer's technical team. Timelines may vary depending on the specific requirements and complexities of the integration; however, integrations using more modern technologies like FHIR APIs can expect quicker implementations and are overall a more efficient method for integration. It’s also important to note that this type of technology is already used within popular EHR systems like Epic, Cerner, and Meditech.
EHR integration facilitates seamless data exchange, reduces manual input errors, and saves valuable time for clinicians, ultimately leading to safer and quicker care for patients. Additionally, the customizability, enhanced usability, and ongoing support associated with these integrations ensure a smooth implementation and optimized user experience. As healthcare continues to embrace technological advancements, the integration of precision medicine tools within EHR systems stands out as a crucial step toward improving patient outcomes and operational efficiency.
Wondering if the EHR-integrated version of InsightRX is right for your organization? Click below to read more on our Integrations page!
Alsowaida YS, Kubiak DW, Dionne B, Kovacevic MP, Pearson JC. Vancomycin Area under the Concentration-Time Curve Estimation Using Bayesian Modeling versus First-Order Pharmacokinetic Equations: A Quasi-Experimental Study. Antibiotics (Basel). 2022 Sep 13;11(9):1239. doi: 10.3390/antibiotics11091239. PMID: 36140021; PMCID: PMC9495010.