Transplant recipients are particularly vulnerable to medication errors because of the large number of chronic drugs needed to prevent rejection and treat comorbidities. Compliance failures directly compromise patient safety through acute immunologic events and premature graft loss. For society, the loss of invested fiscal and organic (organs) resources is catastrophic. As the unique constant in the chain of people who provide, modify, and consume prescription medications, health information technology (HIT) should be focused on empowering the patient to prevent medication errors. The renal failure/transplant population includes a high proportion of minority and indigent people at increased risk of poor health care literacy. Though challenging, this clinical void offers a unique opportunity to bring HIT directly to needy individuals otherwise unlikely to have access. Our principal clinical hypothesis is that HIT can be proven to improve patient safety by minimizing medication errors.
Specific aims address the creation of new knowledge and evidence (in a renal transplant population) of benefits of widely applicable HIT tools. Web-enabled education of two groups, new (<6 months) and established (>6 months), kidney transplant recipients is proposed. First at the bedside and later in the outpatient clinic, all participants will be quizzed on their ability to communicate the """"""""virtual medication list"""""""" they, properly or not, utilize. Randomized, control patients will receive conventional teaching while study patients will learn from four educational modules using wireless Internet access on portable computers. Primary study goals will be improvement in test scores, from which reduced potential and actual medication errors will be inferred. Secondary goals will include reduced serum creatinine, lipids, and Hgb A1C (diabetics), rejection episodes, and hospitalizations. It is hoped that better prescription comprehension and understanding of the transplant process will help patients improve their own compliance and troubleshoot errors made by other providers.
