Overview:
Emily Krohn is Chief Information Officer at Boone County Health Center. Boone County and its five satellite clinics serve approximately ten thousand rural residents in several north central Nebraska counties. At Boone County, Ms. Krohn oversaw improvements to the EHR system which helped the health center prevent adverse medication events and improve patient outcomes.
After Boone County successfully installed an EHR system, Boone County’s medical staff expressed concern with the EHR alerts that were part of the medication list workflow. While the alerts helped the medical staff check for harmful drug interactions and prevent adverse medication events, physicians experienced “alert fatigue” from the constant influx of alerts. In the midst of several minor drug interaction alerts, the health system feared that physicians might miss important alerts. Ms. Krohn and her colleagues knew they needed to improve Boone County’s EHR system to help providers detect drug interactions, prevent medication errors, and improve patient outcomes.
Outcome:
Boone County’s IT staff began the improvement process by engaging providers in discussions about problems with the EHR system. This collaborative process, directed by Ms. Krohn, ultimately led to a successful improvement project to adjust the sensitivity of EHR alerts so providers would avoid alert fatigue. “The health center took a team-based approach to improving our EHR system. As a team, we discussed barriers, identified challenges, and implemented solutions,” explained Ms. Krohn.
Free from the overwhelming amount of drug interaction alerts, providers at Boone County are now better able to manage their patients’ medication lists actively and detect serious drug interactions before adverse medication events occur. As a result of these improvements, Ms. Krohn says, “This provides an additional level of safety for patients visiting the health center, whether at the emergency department, at a remote or onsite clinic, or as an inpatient.”
Lessons Learned:
In part, Boon County credits its team-based approach bringing provider and staff resources together for its positive process and project outcomes.
Next-Steps/Future Vision:
Boone County continues to work as a team to improve its EHR alerts. Key health system stakeholders meet weekly to discuss EHR implementation progress, and, at regular intervals, Ms. Krohn and her colleagues use the EHR system to generate reports showing recently triggered EHR alerts. Boone County uses these reports to provide focused education and training. The training and education helps equip providers to use the EHR to its fullest potential as a tool to help improve patient care.