Taconic Health Information Network and Community (THINC)

Study Overview
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Brief Summary
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The Taconic IPA, a 2,500 physician independent practice association (IPA) located in Fishkill, New York (NY), is involved in an information technology project to improve the quality, safety and efficiency of healthcare in the region. Over the past three years, the organization has worked with area hospitals and laboratories to create a community wide electronic data exchange. Currently, the Taconic IPA is in the midst of implementing a full electronic health record in some practices and e-prescribing in other practices. The purpose is to study the impact of an electronic health record on safety and quality measures.

Detailed Description
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We propose to measure differences in patient safety and quality measures among three groups: the control group consisting of physicians with paper-based office practices, a group of physicians using the clinical messaging system and electronic prescribing, and a group of physicians using the EMR and electronic prescribing. We plan to introduce a vendor based electronic prescribing system by July 2005. This system will be offered to all physicians using clinical messaging and will be integrated with the EMR system. The system will have clinical decision support, such as checks for drug-drug interactions. Our evaluation will measure differences in rates of medication errors and quality measures amongst these three groups. We will use a study design of a pre-post evaluation with a comparison control group. We will detect medical errors by prescription and chart review. We will determine compliance with quality measures through a combination of electronic data and chart review.

Official Title
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Transforming Healthcare Quality Through I.T.

Conditions
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Medication Errors

Intervention / Treatment
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* Device: Electronic Health Record


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Physicians' prescriptions and medical records in office practices enrolled in the study Exclusion Criteria: Other physicians not enrolled in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: The study model used pre-post design of 15 providers who adopted e-prescribing with concurrent controls of 15 paper-based providers from September 2005 through June 2007.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: e-prescribing<br>Providers who used electronic prescriptions. electronic health records were used as opposed to paper based prescriptions | Device: Electronic Health Record<br>* e-prescribing methods<br>|
| No Intervention: Paper-based prescriptions<br>providers who used paper based prescriptions | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication errors |  | 2007-2012 | 
| Near misses |  | 2007-2012 | 
| Adverse drug events |  | 2007-2012 | 
| Quality measures |  | 2007-2012 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Electronic medical records, Electronic prescribing, Quality measures