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UMN Expert: Rethinking chronic kidney disease care through improved electronic health records

Photo: CC, NEC Corporation of America

Chronic kidney disease affects more than 20 million Americans, but primary care providers often miss the condition, because it tends to be asymptomatic and is associated with other important comorbidities, or chronic conditions.

Utilizing electronic health records (EHR) could help identify chronic kidney disease (CKD) sooner, and identify ways to better manage the condition, says University of Minnesota faculty member and researchers with the National Kidney Disease Education Program (NKDEP). Researchers gave recommendations to apply that concept in the Clinical Journal of the American Society of Nephrology today.

“Using EHR data, we can identify high-risk populations, and help providers and patients manage CKD more efficiently,” said Paul Drawz, M.D., lead author of the report, and assistant professor in the Department of Medicine in the Medical School. “It’s possible that EHRs could even improve patient outcomes.”

EHR systems have the potential to improve efficiency and quality of patient care management, physician collaboration, and accuracy for diagnoses and treatments. But current systems tend to be difficult or inconvenient, and lack usability functions that could streamline processes.

“Electronic health records should be built better,” Drawz said. “If we can make it easier for patients and clinicians to access health data in a secure way, we could improve care, satisfaction, and possibly even outcomes.”

How so? One example would be pinpointing medications that would be harmful to people with CKD. Most patients with CKD take several medications, so EHRs could also help physicians and pharmacists identify medications that may be interacting poorly with one another. Another example is that EHRs could provide physicians with better access to a patient’s health data through well-designed flow sheets that include relevant and longitudinal data to help clinicians better diagnose and manage CKD.

EHRs could also supports more robust research projects, the authors pointed out. Readily available population level data could assist in developing stronger research designs or identifying potential clinical trial candidates.

With improved EHRs, researchers, clinicians and patients can find health information faster and more easily, without jeopardizing patient privacy.

To make this possible, the authors recommend:

  • Developing improved, intuitive patient and provider-facing interfaces with secure access
  • Using standard codes and units for CKD related laboratory results and medications
  • Implementing EHR systems that support exchange of CKD-related information across health care settings
  • Expanding functions to allow CKD surveillance and more effective data collection

The NDKEP will explore these options further by collaborating with industry leaders, medical professionals, and researchers. With additional research, the authors are hopeful that the technology and improved processes for EHR-related CKD applications can be implemented.

“We must make improving EHR systems and informatics a priority,” Drawz said. “This could improve care, research and hospital efficiency for many conditions and diseases, not just CKD. When we develop improved EHRs, everybody wins.”

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