HONOLULU, July 9 /PRNewswire/ -- Specialty care physicians can improve the health of high-risk patients by reviewing electronic health records and proactively providing e-consultations and treatment plan recommendations with primary care physicians, according to a Kaiser Permanente paper published online in the British Medical Journal.
The quality improvement project at Kaiser Permanente demonstrated that specialists can take a more active role in managing the health of populations with chronic illness - in this case, kidney disease - by using electronic health records to coordinate care among primary and specialty care providers. In the project, nephrologists (kidney specialists) proactively consulted remotely with primary care doctors to help manage patients at risk for end-stage renal disease.
Using a new system developed by the paper's lead author, Brian J. Lee, MD, and his colleagues at Kaiser Permanente, nephrologists in Hawaii used electronic laboratory results to rank more than 10,000 kidney patients not yet referred to a specialist by their risk for kidney failure. Then, they monitored the patients who were most at risk to make sure they were getting care in line with evidence-based treatment recommendations. After identifying the at-risk patient population, the nephrologists relied on Kaiser Permanente HealthConnect(R), an electronic health record system, to evaluate next steps.
The nephrologists used the EHR to review the patients' electronic medical record and to provide an e-consult to the patients' primary care physicians. In many cases, the nephrologists recommended referral for more intensive specialty care. In others, the primary care physician was given the treatment plan necessary to prevent the need for referral. Results of the five-year project showed it increased early intervention for high-risk patients and reduced by two-thirds the number of late specialist referrals - those
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