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Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts

OBJECTIVES: Lupron 11.25 mg has both a narrow indication and a high cost compared to other Lupron presentations. Prior to our study initiation there was no clear distinction between presentations when ordering within the health-system’s Electronic Health Record (EHR). This resulted in inappropriate...

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Autores principales: Jensen, Chelsee Jo, Honsey, Theresa, Thielen, Michaela K, Spitale, Mari S, Marlette, Bethany J, Kennedy, Erika, Olson, Rachel L, O’Laughlin, Danielle J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772626/
https://www.ncbi.nlm.nih.gov/pubmed/36593683
http://dx.doi.org/10.1136/bmjhci-2022-100669
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author Jensen, Chelsee Jo
Honsey, Theresa
Thielen, Michaela K
Spitale, Mari S
Marlette, Bethany J
Kennedy, Erika
Olson, Rachel L
O’Laughlin, Danielle J
author_facet Jensen, Chelsee Jo
Honsey, Theresa
Thielen, Michaela K
Spitale, Mari S
Marlette, Bethany J
Kennedy, Erika
Olson, Rachel L
O’Laughlin, Danielle J
author_sort Jensen, Chelsee Jo
collection PubMed
description OBJECTIVES: Lupron 11.25 mg has both a narrow indication and a high cost compared to other Lupron presentations. Prior to our study initiation there was no clear distinction between presentations when ordering within the health-system’s Electronic Health Record (EHR). This resulted in inappropriate product selection, payment and billing errors that negatively impact our healthcare system. To reinforce prior education efforts, a new approach was considered leveraging the EHR with information to steer prescribers to the proper Lupron presentation based on indication. This study aimed to reduce off-label prescribing for Lupron 11.25 mg (NDC 00074-3663-03) by 25% by 02/28/2022 without negatively impacting the insurance collection rate. METHODS: Baseline Lupron 11.25 mg adult kit administrations one year prior to intervention and off-label prescribing was found to account for 22.7% of administrations. In December 2021 intervention order questions were added to Lupron 11.25 mg in the EHR. One and two-month data was obtained after implementing order questions within the EHR. Lupron 11.25 mg administrations were classified into one of four categories to determine impact on off-label prescribing. RESULTS: In the one- and two-month post-implementation periods off-label prescribing was 0% and 15.3% respectively, a reduction of 22.7% to and 7.4% respectively from the baseline assessment. There were no clinical denials found in either post-implementation reporting period. CONCLUSION: This report adds to the body of evidence that leveraging the EHR can lead to healthcare savings and illustrates how patient and healthcare system burden can be reduced by prompting thought and direction when a medication has indication specific dose requirements.
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spelling pubmed-97726262022-12-23 Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts Jensen, Chelsee Jo Honsey, Theresa Thielen, Michaela K Spitale, Mari S Marlette, Bethany J Kennedy, Erika Olson, Rachel L O’Laughlin, Danielle J BMJ Health Care Inform Short Report OBJECTIVES: Lupron 11.25 mg has both a narrow indication and a high cost compared to other Lupron presentations. Prior to our study initiation there was no clear distinction between presentations when ordering within the health-system’s Electronic Health Record (EHR). This resulted in inappropriate product selection, payment and billing errors that negatively impact our healthcare system. To reinforce prior education efforts, a new approach was considered leveraging the EHR with information to steer prescribers to the proper Lupron presentation based on indication. This study aimed to reduce off-label prescribing for Lupron 11.25 mg (NDC 00074-3663-03) by 25% by 02/28/2022 without negatively impacting the insurance collection rate. METHODS: Baseline Lupron 11.25 mg adult kit administrations one year prior to intervention and off-label prescribing was found to account for 22.7% of administrations. In December 2021 intervention order questions were added to Lupron 11.25 mg in the EHR. One and two-month data was obtained after implementing order questions within the EHR. Lupron 11.25 mg administrations were classified into one of four categories to determine impact on off-label prescribing. RESULTS: In the one- and two-month post-implementation periods off-label prescribing was 0% and 15.3% respectively, a reduction of 22.7% to and 7.4% respectively from the baseline assessment. There were no clinical denials found in either post-implementation reporting period. CONCLUSION: This report adds to the body of evidence that leveraging the EHR can lead to healthcare savings and illustrates how patient and healthcare system burden can be reduced by prompting thought and direction when a medication has indication specific dose requirements. BMJ Publishing Group 2022-12-20 /pmc/articles/PMC9772626/ /pubmed/36593683 http://dx.doi.org/10.1136/bmjhci-2022-100669 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Short Report
Jensen, Chelsee Jo
Honsey, Theresa
Thielen, Michaela K
Spitale, Mari S
Marlette, Bethany J
Kennedy, Erika
Olson, Rachel L
O’Laughlin, Danielle J
Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
title Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
title_full Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
title_fullStr Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
title_full_unstemmed Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
title_short Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
title_sort clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772626/
https://www.ncbi.nlm.nih.gov/pubmed/36593683
http://dx.doi.org/10.1136/bmjhci-2022-100669
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