Healthcare organizations who treat mental health disorders face numerous challenges including identifying optimal first-line treatments as well as utilizing proper recovery metrics in order to best assess progress. While promise has been demonstrated with the use of pharmaceuticals, individual differences in the response to these medications coupled with non-adherence due to factors such as side effects and rising costs has capped the potential upside. These issues, while surmountable, are exasperated by the inability to provide the prescribing provider relevant information at the point of care within the customary workflow. For instance, advances in pharmacogenetics have produced assays analyzing the genetic code of specific patient enzymes that have proven to be effective in determining better precision choices for medications. These precise reports succeed by empowering the provider with patient-specific information on which medications are most likely to succeed based on the pharmacodynamics of the medication as well as the pharmacokinetic interactions between the patient and drug therapies. However, these reports are most often stored in either paper hard copy or digital format sent via email, inaccessible to the prescribing provider during patient encounters. Similarly, any reliable pricing information is not available until the patient actually fills the prescription. If cost is an issue, at minimum this will result in lost time to the healthcare system and patient alike, and at worse will lead to non-compliance by the patient. Clinical Decision Support (CDS) platforms have emerged as essential tools for addressing these kinds of problems. RxREVU?s RxCHECK platform is a CDS tool designed to empower the provider with the exact information they need for the specific patient they are treating in order to prescribe the best medication available. Hypothesis: Integrating RxCHECK directly into the provider?s clinical workflow via the EHR will allow vital evidence-based information to be surfaced at the point of prescribing. This will lower overall costs to the patient while helping ensure the provider is selecting the best medication based on evidence-based criteria within the clinical guidelines of the organization.
Specific Aims : This project entails the integration of RxCHECK, a prescription focused CDS, into the Mental Health Center of Denver?s (MHCD) Netsmart EHR. The goal is to surface in an efficient, non-disruptive manner, evidence based information including genetic profiles, pricing, and patient adherence metrics. Empowering the provider with the evidence needed in order to choose the best medication for their patient.
The first aim i s centered on converting genetic information from paper and PDF format into a format consumable by MHCD and their EHR.
The second aim concerns the development of the RxCHECK module including the ability to surface this information as well as tracking and reporting of provider adoption of suggested medication changes. The third, and final aim is to integrate the RxCHECK module into MHCD?s Netsmart EHR platform.
The main goal of this proposal is to improve patient outcomes by empowering providers with evidence based information at the point-of-prescribing. In this project, we will extend RxCHECK, clinical support platform, to leverage a patient?s genetic information and provide the prescriber with clinically validated medication guidance for people with mental health issues. Importantly, while we are focusing the project on mental health and pharmacogenomics, this work is readily generalizable to other evidence based metrics that have proven useful in prescribing practices including adherence and pricing information.
