Reducing the Risk of GI Bleeds with Epic

September 3, 2019

Penn Medicine increased preventive prescription rates by 18%

For cardiac patients, the anti-platelet and anticoagulation medications that treat cardiovascular disease also raise the risk of gastrointestinal bleeding. When acid suppression therapy is added to these patients’ medications, it can decrease the risk of GI bleeds, so Penn Medicine implemented a program that boosted these preventive prescriptions by 18%.

To increase adherence to this evidence-based best practice, Penn Medicine used a dashboard integrated with Epic to use data from the chart to identify patients at higher risk of GI bleeds, which guided clinicians to order the acid suppression treatment. After they implemented new workflow processes, which included using the dashboard to help prompt discussions with pharmacists, ordering rates for at-risk cardiac patients increased to cover more than 86% of the patients in the cardiac intensive care unit.

“We demonstrated that although clinical leaders should collaborate to identify best practices, care redesign, technology, and behavior change strategies are also needed,” said Dr. Shivan Mehta, Penn Medicine’s associate chief innovation officer.

The project was part of a Penn Medicine study to determine the effect of clinical education and EHR tools on ordering rates for acid suppression therapy. The study determined that guidance using Epic was more effective than education alone. Penn Medicine is now implementing additional specialty dashboards in Epic to increase adherence to other evidence-based best practices.