EMRs Shown to Improve Care

A treatment program in which nephrologists used an EMR to remotely monitor the care of patients with mild to moderate kidney disease has reduced by two-thirds the number of specialist referrals that took place too late in the course of the disease.

Brian Lee, a Kaiser nephrologist based in Hawaii, published these findings in the British Medical Journal.

Lee and associates used Kaiser’s HealthConnect system to track progress of patients having elevated serum creatinine levels to assure they received care consistent with evidence-based treatment guidelines.

They suggested referral to a specialist or provided treatment plans for implementation by PCPs as they deemed necessary.

"The goal with kidney disease is to detect it early enough to make changes that will slow the disease down,” Lee told BurrillReport. “Patients who consult with a nephrologist before the onset of kidney failure are less likely to be hospitalized and more likely to survive longer.”

In a separate study funded by the National Cancer Institute, Kaiser’s EMR was found to boost mammography screening rates by 17% among women who should receive them.

Participants were female Kaiser Permanente Northwest HMO members aged 42-49 years old that had not received the breast cancer screening test in at least 20 months.

After identifying eligible patients, the Kaiser system mailed out a “mammogram due soon” postcard to them. This was followed by up to 2 automated phone calls and then a live call for nonresponders.

Before the system was instituted, 63.4% of targeted women completed a mammogram. This number increased to 75.4% during the initial implementation phase of the program, and to 80.6% during a maintenance phase.

The write-up appears in the American Journal of Preventive Medicine.

Glenn Laffel, MD, PhD, Sr. VP Clinical Affairs