Clinical Decision-Support Tools
(Developed through the eCLINICIAN Project)
|Bioterrorism, Emergency Preparedness||CDC|
|Blood Pressure (BP) Control||NHLBI (JNC-VII)|
|Chronic Kidney Disease (CKD)||NHLBI|
|HIV / AIDS||AIDSinfo|
|Obesity / Nutrition||NHLBI|
|Tobacco Control/ Smoking Cessation||SmokeFree|
|ePocrates (Drug Reference)
|WISER (Hazardous Substances)||https://wiser.nlm.nih.gov/||NLM|
|ePSS (USPSTF Preventive Health Recommendations)||AHRQ/USPSTF|
|Hepatitis C Virus||USPSTF|
**The ePrescribing Pilot Project was carried out in 2005 by CDN and DOHMH. The following is from the 2005 Project Overview.**
Building on the successful eClinician Primary Care Information Project, DOHMH is working with CDN to perform an ePrescribing Pilot Project. The ePrescribing Pilot Project explores the utility of using PDA and desktop computers to safely and securely prescribe pharmaceuticals. It is estimated that up to 98,000 Americans die from medical errors annually ( Institute of Medicine , 2000 report). Many of these adverse events are associated with the use of pharmaceuticals, and are potentially preventable. The IOM estimates the number of lives lost to preventable medication errors alone represents over 7,000 deaths annually.
A wide body of research, including many studies funded by AHRQ, supports the IOM conclusions. By computerizing the prescription order entry process, the ePrescribing system will eliminate many of the factors that contribute to medication errors including poor handwriting and inaccurate dosing. In addition to improving patient safety, electronic prescribing will help clinicians increase patient safety, save time, reduce pharmacy and patient callbacks and improve office efficiency. During an emergency, this process will also assist providers in identifying the proper pharmaceuticals to treat patients who may have been exposed to a WMD agent.
CDN and DOHMH interviewed existing electronic prescribing software companies and selected a vendor (Allscripts) based on their product, ePrescribing market share and previous experience working with other health centers. Also, based on the assessments done in terms of practice management systems, technical support, location, patient population and provider expertise with computers and PDAs, four Federally Qualified Health Centers (FQHCs) have been selected to participate in this pilot project. Allscripts provides electronic prescribing licenses to 40 primary care providers from these four health centers for a period of one year. These providers have been asked to write their prescriptions using the electronic prescribing tool they received. Prior to providing the eRx tool, CDN has ensured that the providers are comfortable with their PDAs and computers in general. The ePrescribing vendor prepares monthly summaries of provider utilization that will be shared with DOHMH and CDN. Pre and post usage survey tools have been developed by the Columbia University Department of Biomedical Informatics to measure the provider satisfaction and to identify the barriers to eRx adoption in these health centers.
Based on the success of this pilot project, this project will be extended to all the community health centers in New York City. The four FQHCs participating in this pilot project are:
- Morris Heights Health Center (Bronx, NY),
- Joseph P. Addabbo Family Health Center (Arverne, NY),
- Brownsville Multi-Service Center for Family Health (Brooklyn, NY),
- Community Health Network (Manhattan, NY).
The ePrescribing vendor selected for this initiative is Allscripts, www.allscripts.com (Chicago, IL). Allscripts is the provider of clinical software, connectivity, and information solutions for more than 20,000 physicians across the country. Their award-winning solutions helps connect physicians to each other and to the entire community of care including patients, hospitals, labs, and pharmacies, providing a more seamless patient experience. Allscripts is comprised of three business groups with leaders and innovators in the markets they serve- Clinical Solutions Group, Physicians Interactive Group and Medication Services Group. ePrescribing product is managed by Clinical solutions group. Laurie McGraw, President of the Clinical Solutions Group, has a ten-year tenure working with IDX and she recently served on the 2004 Board of Examiners for the Baldrige National Quality Program. Allscripts has strategic partnership with companies like IDX systems, Microsoft, HP, Intel, Cisco and Labcorp.
ePrescribing Product Overview: Touch Script
Their award-winning TouchScript e-prescribing solution is the industry’s most trusted and widely used e-prescribing software in the United States today. About 55% of electronic prescriptions are being written using TouchScript, available for Pocket PC’s,
desktop, laptop and Tablet computers. It won the honors in TEPR (Towards Electronic Patient Record) eHealth awards for the years 2004 and 2005. Allscipts major strengths are their proven track record, experience working with other health centers with similar work flow, partnership with market leaders like Microsoft, about 55% market share in ePrescription products, in-depth understanding of pocket PCs, customized report generation capabilities.
References: reports, recommendations, case studies and white papers
” Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus whitepaper, we set forth recommendations and action plans.”
Teich JM, Osheroff JA, Pifer EA, Sittig DF, Jenders RA, Panel TC. Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan. J Am Med Inform Assoc. 2005 Jul-Aug;12(4):365-76. [ PubMed ]
Electronic Prescribing: Towards Maximum Value and Rapid Adoption: Recommendations for Optimal Design and Implementation to Improve Care, Increase Efficiency and Reduce Costs in Ambulatory Care (eRx Report). A Report of the Electronic Prescribing Initiative, eHealth Initiative. Washington , D.C. April 14, 2004 [ eHealth Initiative ]
( The eHI is an independent, Washington DC-based non-profit group promoting the use of information technology to improve health care. )
Electronic Prescribing Can Reduce Medication Errors: White Paper from the Institute for Safe Medication Practices, 2000 [ ISMP ]
Miller RA, Gardner RM, Johnson KB, Hripcsak G. Clinical decision support and electronic prescribing systems: a time for responsible thought and action. J Am Med Inform Assoc. 2005 Jul-Aug;12(4):403-9. [ PubMed ]
Bates DW, Teich JM, Lee J at al. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc. 1999 Jul-Aug;6(4):313-21. [ PubMed ]
Bell DS, Friedman MA. E-prescribing and the medicare modernization act of 2003. Health Aff (Millwood). 2005 Sep-Oct;24 [ PubMed ]
We all want to be as healthy as possible. But there’s so much information, it can be hard to know what’s most important. That’s why the New York City Department of Health and Mental Hygiene wants to make it simple.
TAKE CARE NEW YORK consists of 10 steps people can take now to live longer, healthier lives. The following are Take Care New York Action Steps to improve your health, with specific things you can do, along with Additional Resources to help you follow through.
We’ve concentrated on 10 core health issues that have the biggest impact on your health. If all of us took just some of these steps, we could prevent thousands of deaths and hundreds of thousands of illnesses and disabilities each year.
Why These 10?
|1. Have a Regular Doctor or Other Health Care Provider|
|2. Be Tobacco Free|
|3. Keep Your Heart Healthy|
|4. Know Your HIV Status|
|5. Get Help for Depression|
|6. Live Free of Dependence on Alcohol and Drugs|
|7. Get Checked for Cancer|
|8. Get the Immunizations You Need|
|9. Make Your Home Safe and Healthy|
|10. Have a Healthy Baby|
eClinician Project Staff
Mat Kendall, MPH, Project Director
The New York City Department of Health and Mental Hygiene
Richard Younge, MD, MPH
Clinical Directors Network, Inc. (CDN)
Community Health Care Association of New York State (CHCANYS) CEOs
Community Health Care Association of New York State
Dist. Learning Manager / CIO
Raj Adusumilli, MD, MS
Clinical Directors Network, Inc. (CDN)
Community Health Care Association of New York State
About: In 2005, The New York City Department of Health and Mental Hygiene (NYCDOHMH), Community Health Care Association of New York State (CHCANYS) and Clinical Directors Network, Inc. (CDN), worked together on an initiative called the eClinician Project. The eClinician Project provided free, public health-friendly customized PDAs with clinical decision-support software to primary care clinicians working in NYC Community Health Centers. A critical element of the project included onsite and online training through Webcast Library to train clinicians on how to use electronic clinical decision-support tools.
- Improve Disease Management among physicians by providing electronic support tools
- Improve clinician quality of care and services
- Provide clinicians with ongoing evidence-based medicine training
- Provide emergency preparedness alerts to clinicians
- Provide onsite trainings to educate providers on using wireless tools in their practices
- To enable providers the ability to access the health alert network during emergencies