Computerized Provider Order Entry

Slides from a presentation given at the UNM Health Sciences Center

Nonadherence to Oral Antihyperglycemic Agents: Subsequent Hospitalization and Mortality among Patients with Type 2 Diabetes in Clinical Practice

Using real-world clinical data from the Indiana Network for Patient Care, we analyzed the associations between non-adherence to oral antihyperglycemic agents (OHA) and subsequent diabetes-related hospitalization and all-cause mortality for patients with type 2 diabetes. OHA adherence was measured by the annual proportion of days covered (PDC) for 2008 and 2009. Among 24,067 eligible patients, 35,507 annual PDCs were formed. Over 90% (n=21,798) of the patients had a PDC less than 80%. In generalized linear mixed model analyses, OHA non-adherence is significantly associated with diabetes related hospitalizations (OR: 1.2; 95% CI [1.1,1.3]; p<0.0001). Older patients, white patients, or patients who had ischemic heart disease, stroke, or renal disease had higher odds of hospitalization. Similarly, OHA non-adherence increased subsequent mortality (OR: 1.3; 95% CI [1.02, 1.61]; p<0.0001). Patient age, male gender, income and presence of ischemic heart diseases, stroke, and renal disease were also significantly associated with subsequent all-cause death

Factors Influencing Progress of Health Information Exchange Organizations in the United States

Progress is being made toward improved healthcare interoperability in the United States, but exchange between electronic health records alone is insufficient. Using data from the eHealth Initiative's Annual Survey of Health Information Exchange, we developed models of HIE financial and operational progress. Our analysis suggests that organizations that focus on enabling exchange thorugh education and policy need to be considered separately from those focused on the actual exchange. The associations between characteristics and progress in data exchanging HIEs suggest that diversity of participants as both originators and receivers of data and breadth of data are important underlying success factors