Kaiser protocol helps CHCs improve diabetes treatment

June 12, 2015 in Medical Technology

Community health centers in Oregon were able to realize some substantial medication administration improvements after implementing an EMR protocol pioneered by Kaiser Permanente.

[See also: QA: Kaiser Permanente CIO Dick Daniels]

Kaiser’s ALL protocol focuses on clinical decision support that reminds providers to prescribe hypertension medications (ACE-inhibitors) and/or lipid-lowering medications (statins) for people with diabetes, who are often at increased risk for heart attacks and strokes.

A report published this week in Implementation Science found that prescriptions for a medication regimen to reduce heart attacks and strokes in patients with diabetes increased by nearly 40 percent in 11 clinics after the CHCs implemented the “ALL” quality improvement guidelines.

[See also: Community health center directors say HIT holds promise for care]

“This is the first clinical trial to test how a care improvement program developed by a private, integrated health system can be successfully implemented in a public health system that serves millions of low-income and uninsured patients,” said Rachel Gold, researcher with the Kaiser Permanente Center for Health Research and the study’s lead author, in a press statement.

“With more at-risk patients in these clinics on cardio-protective medications, the hope is that they will have a reduced risk for heart attacks and strokes,” she said.

The clinics highlighted in the study share a centralized electronic medical record through OCHIN, a not-for-profit health information netwrork that focuses on safety-net clinics.

OCHIN added alerts to the providers’ EMRs to notify clinicians when patients met the right guidelines to receive the medications, and shortcuts to expedite ordering the medications. These EMR tools were modeled after ALL protocol, but were adapted for the community health centers.

Before the tools were added, about 45 percent of the community health center patients who met the clinical guidelines received the medications. After the tools were added, that number rose to 63 percent.

The study “shows how we are doing that, and it sets the stage for Kaiser Permanente and other private health systems to share best practices with public health systems that care for the nation’s most vulnerable patients,” said Winston Wong, MD, medical director, Kaiser Permanente Community Benefit, in a statement.

Since being developed in 2003, the ALL protocol has been adopted by 55 community health centers serving approximately 80,000 patients in four states.

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