Scientists at the National Institute of Mental Health (NIMH) www.nimh.nih.gov and the Veterans Health Administration (VHA) www.va.gov/health/aboutvha.asp are using data from EMRs to identify very small groups of individuals within the VHA patient population that indicate they are a high predicted suicide risk.
“As the largest healthcare provider in the U.S, the VA has the responsibility to examine how our extensive suicide prevention efforts are working and identify opportunities for improvement,” reports Dr. Caitlin Thompson, Deputy Director for Suicide Prevention for the VA.
The VHA care system identifies patients as being at high risk for suicide based on information assessed during clinical encounters and from their EMRs. Researchers have found that their predictive model was more sensitive than clinical flagging.
In another research project relying on information from electronic records, the Tennessee Valley Health Care System in Nashville www.tennesseevalley.va.gov is studying hospitalized patients with Acute Kidney Injury (AKI) as to why these patients have a significant elevated inpatient mortality risk and post-discharge morbidity.
The incidence of AKI among the general U.S. population ranges from 1 to 5 percent in all hospital admissions and up to 20 percent in intensive care patients. It appears that the veteran population is more complex than the general population and therefore is at an increased risk for AKI.
The funding for the AKI project started in 2009 and slated to end in August, obtains information available from EHRs. This was done to establish the necessary informatics infrastructure and obtain data medication-related AKI.
The steps were to review the literature for evidence on risk factors related to AKI, develop automated data extraction protocols for the data, establish the expected event rates, and evaluate the outcomes.
The goal is to identify new risk factors for AKI in the VA population as well as characterize the magnitude of risk for known nephrotoxic medications. Establishing a medication surveillance system in the VA to determine the unknown risk factors for AKI among hospitalized VA patients, should lead to improved overall patient safety.