June 25, 2015
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Electronic health records can improve care for chronic kidney disease patients

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A new paper published in the Clinical Journal of the American Society of Nephrology identifies general strategies for using electronic health records to improve care for patients with chronic kidney disease. Paul Drawz, MD, MHS, MS from the University of Minnesota), Uptal Patel, MD, from Duke University School of Medicine, and their colleagues within the National Kidney Disease Education Program's Health Information Technology Working Group created the guidance over the course of two years.

The group has identified strategies for using EHRs to improve care for patients with CKD, and they outline specific design features and goals for incorporating CKD-related data into EHRs. They advocate for documenting CKD-related data (such as laboratory results and information related to risk factors and medical complications) into EHRs using standard code systems and units. For example, systolic and diastolic blood pressure should be stored in separate fields, rather than in a single field separated by a slash. Additionally, they recommend storing CKD-related data in formats that can be easily accessed by patients and clinicians. EHRs could also be used to develop CKD registries so that clinicians can manage panels of patients and coordinate care with other specialties.

Several characteristics make CKD an ideal model for identifying and evaluating methods for more effectively designing and using EHRs to allow clinicians to better care for patients with chronic conditions, the authors said.

"CKD is common and its care is suboptimal, allowing significant room to show improvement as EHRs are optimized, and because CKD is defined by objective data, the disease is an ideal example of a condition that can be easily identified by information commonly found in EHRs," said Patel, who is chair of the working group. "CKD care also requires collaboration between diverse professionals across numerous healthcare settings, which could be facilitated by EHRs. Furthermore, CKD often heralds increased risk for hospitalizations, cardiovascular events, and all-cause mortality, so EHR-based improvements in CKD management may in turn improve care for these related conditions."

The National Institute of Diabetes and Digestive and Kidney Diseases will host a conference for stakeholders in CKD health information technology, population health management, and public health research Oct. 22 to 23 on Bethesda, Md. to begin to identify specific solutions for the recommendations. -by Rebecca Zumoff