J Am Pharm Assoc (2003). 2018 Jul-Aug;58(4):442-449. doi: 10.1016/j.japh.2018.02.012. Epub 2018 Apr 4.
To describe the incorporation of a state health information exchange (HIE) into a community pharmacy transitions of care (TOC) service and to assess its impact on 30-day readmission rates.
Three suburban community pharmacies in Olathe, Kansas.
Balls Food Stores is a grocery store chain which operates 21 supermarket community pharmacies in the Kansas City metropolitan area.
Balls Food Stores launched a pharmacist-led self-referral TOC study in which a state HIE was utilized to collect discharge information from patients' electronic medical records (EMRs) to facilitate TOC comprehensive medication reviews (CMRs).
Descriptive statistics were used to assess types and outcomes of identified drug therapy problems and the ability to access Kansas Health Information Network EMRs. A chi-square test was used to assess 30-day readmissions between patients who accepted and declined the service.
Forty patients were identified for inclusion and 18 elected to participate in the service. The majority of participants were white females with a median age of 64.5 years. Out of 40 study patients, 85% had an EMR available; 12.5% of patients had a medication list included in their EMR hospitalization documentation. Participants who underwent the service had a statistically significantly lower rate of overall 30-day hospital readmission than those who declined (11.1% vs 36.4%, P = 0.032). Among the 18 TOC CMRs performed, 90 drug therapy problems were identified and 77 were resolved in collaboration with a patient, caregiver, or physician.
Incorporation of a state HIE into a community pharmacist-led TOC service is a novel strategy for collecting patient data. During the study, no TOC participants were readmitted within 30 days. However, pharmacists found HIE data alone was insufficient to perform TOC CMRs for the majority of participants. In order to expand state HIE utilization, more health systems will need to upload a minimum standard data set to help facilitate care.
描述将州健康信息交换（HIE）纳入社区药房过渡护理（TOC）服务中，并评估其对 30 天再入院率的影响。
堪萨斯州奥拉西的三家郊区社区药房。
Balls Food Stores 是一家杂货店连锁店，在堪萨斯城大都市区经营 21 家超级市场社区药房。
Balls Food Stores 启动了一项由药剂师主导的自我转诊 TOC 研究，该研究利用州 HIE 从患者的电子病历（EMR）中收集出院信息，以促进 TOC 全面药物审查（CMR）。
使用描述性统计数据评估确定的药物治疗问题的类型和结果，以及访问堪萨斯健康信息网络 EMR 的能力。使用卡方检验评估接受和拒绝服务的患者之间的 30 天再入院率。
确定了 40 名符合条件的患者，其中 18 名患者选择参加该服务。大多数参与者是白人女性，中位年龄为 64.5 岁。在 40 名研究患者中，85%的患者有 EMR 可用；12.5%的患者在其 EMR 住院记录中包含了用药清单。接受该服务的患者总体 30 天内再入院率明显低于拒绝该服务的患者（11.1%比 36.4%，P=0.032）。在进行的 18 项 TOC CMR 中，确定了 90 个药物治疗问题，并与患者、护理人员或医生合作解决了 77 个问题。
将州 HIE 纳入社区药剂师主导的 TOC 服务是收集患者数据的一种新策略。在研究期间，没有 TOC 参与者在 30 天内再次入院。然而，药剂师发现仅使用 HIE 数据不足以对大多数参与者进行 TOC CMR。为了扩大州 HIE 的使用，更多的医疗系统将需要上传最小标准数据集，以帮助促进护理。
