Use of the Electronic Health Record to Optimize Antimicrobial Prescribing

Parzen-Johnson, Simon; Kronforst, Kenny; Shah, Rohan; Whitmer, Grant R.; Scardina, Tonya; Chandarraju, Meg; Patel, Sameer

doi:10.1016/j.clinthera.2021.09.009

Cited by 11 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 This may be combined with EMR-based prompts, such as targeted prescribing alerts that notify prescribers about potential DDIs and the presence of renal dysfunction, given that these were frequently overlooked in our study. 14 The findings from this study were forwarded to the statewide EMR committee, which has governance over electronic prescribing. We believe that these findings could suggest the need for prescribing alerts for these agents in the EMR.…”

Section: Discussionmentioning

confidence: 99%

Prescribing of antivirals for COVID‐19 in a South Australian local health network according to statewide guidelines

Al Naji,

Inglis,

Tucker

et al. 2024

Internal Medicine Journal

View full text Add to dashboard Cite

Antiviral drugs were rapidly implemented into clinical practice for the treatment of high‐risk patients with COVID‐19, prompting the development of statewide guidelines. This South‐Australian study reviewed guideline adherence, assessed prescribing patterns and highlighted the inappropriate management of relative drug–drug interactions and dosing for renal function. Additionally, it evaluated the impact of inappropriate antiviral drug use and suggested methods to improve quality use of medicines.

show abstract

Section: Discussionmentioning

confidence: 99%

Prescribing of antivirals for COVID‐19 in a South Australian local health network according to statewide guidelines

Al Naji,

Inglis,

Tucker

et al. 2024

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…In the US, following the Health Information Technology for Economic and Clinical Health (HITECH) Act, adoption of EHR was financially incentivized by the Centers for Medicare and Medicaid Services 46–48 . Most EHR systems offer built‐in modules to facilitate the workflow for AMS interventions, and reporting of pertinent quality improvement metrics such as antimicrobial consumption and nosocomial Clostridioides difficile infection rates 46–52 . These advanced EHR systems provide clinical decision support tools, such as syndrome‐specific order sets, best practice advisories, and recommended dosing to guide the prescriber at point‐of‐care.…”

Section: What Are the Implications Of Electronic Health Record Systems?mentioning

confidence: 99%

“…[46][47][48] Most EHR systems offer built-in modules to facilitate the workflow for AMS interventions, and reporting of pertinent quality improvement metrics such as antimicrobial consumption and nosocomial Clostridioides difficile infection rates. [46][47][48][49][50][51][52] These advanced EHR systems provide clinical decision support tools, such as syndrome-specific order sets, best practice advisories, and recommended dosing to guide the prescriber at point-of-care. They can streamline the information gathering process, thereby improving the efficiency in adjudicating appropriateness of use by syndrome or by antimicrobial, irrespective of which auditing tool is used.…”

Section: What Are the Implications Of Electronic Health Record Systems?mentioning

confidence: 99%

Auditing tools for antimicrobial prescribing in solid organ transplant recipients: The why, the how, and an assessment of current options

Nakamachi

Thursky

2022

Transplant Infectious Dis

View full text Add to dashboard Cite

Background Antimicrobial stewardship (AMS) aims to optimize antimicrobial use. Auditing and reporting of antimicrobial prescribing are essential. Auditing tools for solid organ transplant (SOT) patients should tailor to their needs. Methods We reviewed published data describing auditing tools in the general and SOT population. Results We focused on three internationally or nationally available auditing tools. The National Antimicrobial Prescribing Survey (NAPS) is web‐based tool to report antimicrobial consumption and assess appropriateness using standardized definitions based on consensus guidelines. In the absence of guidelines, adjudication is based on AMS principles. An automated dashboard, analyses by indication or antimicrobial, and benchmarking reports are available. The National Healthcare Safety Network Antimicrobial Use/Resistance module was developed by the Centers for Disease Control and Prevention for hospitals to upload monthly data, which are standardized for benchmarking. It does not assess appropriateness or address SOT wards. The Global‐Point Prevalence Survey from bioMérieux collects data on antimicrobial regimen, indication and microbial resistance. Variables unique to SOT include comorbidities and devices. Assessment of appropriateness is limited to guideline adherence, and benchmarking may require prearrangement with bioMérieux. Benchmarking requires prearrangement. Advances in electronic health record systems and clinical decision support tools can improve the efficiency of the auditing process. Conclusion Each AMS auditing tool has unique features for SOT patients. Capturing immunosuppression, source control, organ dysfunction, donor‐derived infection, serology, and colonization status will enhance their applicability.

show abstract

“…Clinical decision support systems, which can be voluntary options for healthcare professionals, have been used to steer antibiotic prescriptions in primary care and enhance the stewardship of the antibiotics that are available 3 . In addition, models have been constructed for obligatory EHR‐based interventions, such as guiding the use of antibiotic prescriptions, providing counselling, benchmarking, tailored education and even restrictions 4 . However, these interventions have not been put in place until now, with the exception of the voluntary use of decision support systems.…”

mentioning

confidence: 99%

“…3 In addition, models have been constructed for obligatory EHR-based interventions, such as guiding the use of antibiotic prescriptions, providing counselling, benchmarking, tailored education and even restrictions. 4 However, these interventions have not been put in place until now, with the exception of the voluntary use of decision support systems. The next step is to integrate these steering tools into the core of the electronic platforms.…”

mentioning

confidence: 99%