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5. Better quantitative risk assessment and use of electronic information systems

Dr. Boland

The current national push for Electronic Health Records (EHRs) is motivated by the desire to improve the quality and safety of patient care by better using information that is currently obscured by being confined to a paper chart. GCE physicians have been documenting patient encounters using computerized systems for 10 years and have recently upgraded to a fully functional EHR. This means that the important information about each patient visit is stored electronically to improve quality and efficiency of patient care.

Our EHR improves care by ensuring that all information is available at every care site, by avoiding dangerous drug interactions and allergies, and by displaying information in ways that help physicians make better clinical decisions.  The medical information is only available to those who need access. The EHR used in the GCE also facilitates evaluation of the quality of care that we provide and assesses the effect of changes in visits or testing.  The GCE is the first group within the Wilmer Eye Institute and among in all of Johns Hopkins Medicine to make this quality improvement

In keeping with our commitment to research that improves patient care, we are evaluating the impact of the EHR on our practice.  Since the EHR is now involved in all portions of a patient encounter, such impact is important and our results will help other physicians, not just glaucoma specialists as they transition to electronic records.  These studies will evaluate how frequently testing should be done, how well physicians interpret and use exams and tests, and how doctors make decisions on treatment. The studies will directly test the effect of presenting doctors with risk calculation data so that their choices to treat or how to treat are informed by electronically generated data, as well as clinical judgment.

This research will be conducted nationally through the Glaucoma Research Network that is described separately here (priority area 4) with its plan and budget.

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