Healthcare decision making and EHR Reports

The data warehouse for our large group practice at Metro-Care was used to evaluate completeness of documentation for post-acute myocardial infarction (AMI) care. Documentation elements were pulled for a year of the practice’s experience, including medications prescribed post-AMI for beta blockers, ACE inhibitors, and aspirin (ASA). The standard of care for post-AMI includes these medications. Also pulled and analyzed was whether or not documentation in the medical record mentioned contraindications to the specific drug therapies of ASA or beta blockers.

Three physicians (Dr. McConnelly, Dr. Ayala, and Dr. Rice) did most of the post-AMI care at the group practice:

1. Dr. McConnelly had a high rate of prescribing the necessary medications, such as aspirin.

2. Dr. Ayala had a mid-range level of prescribing, but her patient’s medical records usually contained documented contraindications, such as stomach ulcers which contraindicate aspirin use.

3. Dr. Rice had the lowest level of prescribing for aspirin and beta blockers and also did not routinely document contraindications.

How would you share this information with Dr. Rice? What could you say about the data analysis and results to help convince Dr. Rice to follow the standard of care for post-AMI?