Can a chronic disease model be used to improve EHRs?

Well-designed EHRs enable clinicians to monitor and care for patients with long-term conditions, increase the continuity of services, facilitate collaboration between providers and support patient self-management. However, the potential of EHRs to improve chronic disease care and research has yet to be fully realized due to design limitations.

Using a chronic disease model, such as chronic kidney disease, could be a way to incorporate a chronic disease care infrastructure into EHR, according to research published in the Clinical Journal of the American Society of Nephrology. Several characteristics of CKD make it an ideal model for identifying and evaluating methods for more effective EHR design and use, according to the researchers.

"CKD is common and its care is suboptimal, allowing significant room to show improvement as EHRs are optimized," Uptal Patel, MD, chair of the National Kidney Disease Education Program's Health Information Technology Working Group, said in a statement.

The working group advocate for documenting data related to CKD, such as laboratory test results and information related to risk factors and medical complications, into EHRs using standard code systems and units. They also expect that EHRs could be used to develop CKD registries so that clinicians can manage groups of patients and coordinate care across specialties.

"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. 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."

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