EHRs, hard-stop alerts for drugs among top HIT tools in fighting pandemic, study finds

Researchers investigated how four American hospitals with a long history of health information technology responded to the COVID-19 pandemic and outlined the three most useful technologies, according to a March 13 study published in the Journal of the American Medical Informatics Association.

Researchers hosted interviews with 44 healthcare professionals with backgrounds in informatics from four American hospitals and two British hospitals that are technologically mature. They surveyed the healthcare professionals on what they perceived were the most effective HIT tools.

Three health technologies were perceived to be the most effective for patient treatment and management of resources.

Here are those three technologies and how they worked:
1. Hospitals were able to track real-time bed capacity during patient surges with EHRs.
Linking infection control risks and reports on bed utilization so staff can see how many patients are in COVID-19 precautions in the hospital was useful, an unnamed American physician said in the report.

"You can really have a window in terms of your bed efficiency and blocked beds, if you need private rooms for COVID-positive patients," one physician said. "And so that really drove a large system change around linking bed assignments, electronic infrastructure for bed assignments, to orders for precautions, to lab results."

2. Hard-stop alerts and order sets helped to respond to medication shortages and finding alternative available medications.
Tocilizumab, a prescription drug used to treat rheumatoid arthritis, was incorrectly being prescribed to COVID-19-positive patients, causing drug shortages for those who needed it.

In response, two U.S. hospitals of the four developed hard-stop alerts to block physicians from ordering incorrect drugs for COVID-19 patients.

"If the patient was COVID-positive and ordered tocilizumab, it blocked them, but if they ordered tocilizumab for a patient who was not COVID positive, [the system] allowed it to go through," an unnamed U.S. pharmacy manager said in the report.

3. Telehealth and remote working capabilities were used to lower the number of individuals at the hospital.
"Before COVID-19, we were doing 30 telemedicine visits a week," an unnamed U.S. chief medical informatics officer stated in the report. "Now we're over 4,000 a day. [With our] adoption of a patient portal, it went from 30 percent to about 75 percent. COVID has, you know, completely changed things."


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