Clinical trial NCT00225563: Taconic Health Information Network and Community (THINC)
Official title: Transforming Healthcare Quality Through I.T.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Medication Errors
Keywords: Electronic medical records
Electronic prescribing
Quality measures
Lead sponsor: Weill Medical College of Cornell University
Sponsor class: OTHER
First posted: 2005-09-26
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: FACTORIAL
Intervention 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.
Primary purpose: PREVENTION

Brief summary: 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: 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.

Eligibility criteria: Inclusion Criteria:

* Physicians' prescriptions and medical records in office practices enrolled in the study

Exclusion Criteria:

* Other physicians not enrolled in the study

Primary outcomes:
measure: Medication errors
timeFrame: 2007-2012
measure: Near misses
timeFrame: 2007-2012
measure: Adverse drug events
timeFrame: 2007-2012
measure: Quality measures
timeFrame: 2007-2012
Secondary outcomes:
Other outcomes:
Locations:
city: Fishkill
country: United States
facility: Taconic IPA
state: New York
Study officials:
affiliation: Taconic IPA
name: A. John Blair, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Partners Health Care
name: Rainu Kaushal, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Abramson EL, Barron Y, Quaresimo J, Kaushal R. Electronic prescribing within an electronic health record reduces ambulatory prescribing errors. Jt Comm J Qual Patient Saf. 2011 Oct;37(10):470-8. doi: 10.1016/s1553-7250(11)37060-2.
citation: Kaushal R, Kern LM, Barron Y, Quaresimo J, Abramson EL. Electronic prescribing improves medication safety in community-based office practices. J Gen Intern Med. 2010 Jun;25(6):530-6. doi: 10.1007/s11606-009-1238-8. Epub 2010 Feb 26.