Innovative medical records software developed by
geriatricians and informaticians from the Regenstrief Institute and the Indiana
University Center for Aging Research will provide more personalised health care
for older adult patients, a population at significant risk for mental health
decline and disorders.
A new study published in eGEMs, a peer-reviewed online
publication recently launched by the Electronic Data Methods Forum, unveils the
enhanced Electronic Medical Record Aging Brain Care Software, an automated
decision-support system that enables care coordinators to track the health of
the ageing brain and help meet the complex biopsychosocial needs of patients and
their informal caregivers.
How it works
The eMR-ABC captures and monitors the cognitive, functional,
behavioural and psychological symptoms of older adults suffering from dementia
or depression. It also collects information on the burden placed on patients'
Utilising this information, the software application
provides decision support to care coordinators, who, working with physicians,
social workers and other members of the health care team, create a personalized
care plan that includes evidence-based non-pharmacological protocols,
self-management handouts and alerts of medications with potentially adverse
cognitive effects. The software's built-in engine tracks patient visits and can
be used to generate population reports for specified indicators such as
cognitive decline or caregiver burnout.
"The number of older adults is growing rapidly.
Delivering personalised care to this population is difficult and requires the
ability to track a large number of mental and physical indicators," said
Regenstrief Institute investigator Malaz Boustani, M.D., MPH, associate
director of the IU Center for Aging Research and associate professor of
medicine at the IU School of Medicine. He is senior author of the new study.
"The software we have developed will help care coordinators measure the
many needs of patients and their loved ones and monitor the effectiveness of
individualised care plans."
In clinical trials over the past decade, Regenstrief and the
IU Center for Aging Research investigator-clinicians developed and demonstrated
the efficacy of an Alzheimer's disease collaborative care model called the
Aging Brain Care Medical Home. A hallmark of the ABC-MedHome is the employment
of care coordinators who help clinicians identify and manage processes and
protocols for Alzheimer's patients who receive care in local primary care
physician offices. The ABC-MedHome has been shown to improve the quality of
Alzheimer's care and decrease its burden on the health care system.
Within the ABC-MedHome program, Dr. Boustani and colleagues
have now developed, tested, implemented and improved software that is sensitive
to the clinical needs of a multispecialty team of professionals who provide
care to complex patients across a variety of settings. The new software allows
tracking of individual patient health outcomes as well as the ability to follow
the status of an entire patient population with key quality, health and cost
"Integration of the eMR-ABC program within
Wishard-Eskenazi Health was pivotal to our receipt in 2012 of a Health Care
Innovation Challenge award from the Centers for Medicare & Medicaid
Services to expand from care of 250 patients to 2,000 patients plus
caregivers," said Dr. Boustani, who is medical director of the Wishard
Healthy Aging Brain Center and also an IU Health geriatrician. "New models
of care, supported by population health management tools, are needed if we are
to provide improved quality of care and encourage better health outcomes for
our patients and be cost sensitive. We are using health information technology
to manage high-risk populations while achieving the triple aim of better health
and better care at lower cost."