New strategies for combatting chronic kidney disease, other long-term conditions

The proposed strategies appear in the current issue of the Clinical Journal of the American Society of Nephrology.

EHRs can help clinicians monitor and care for patients with long-term conditions such as chronic kidney disease. EHRs can also increase the continuity of services, facilitate collaboration between providers, and support patient self-management. Unfortunately, the potential of EHRs to improve chronic disease care and research has yet to be realized due to limitations in the design and use of EHRs for both clinicians and patients.

In the article, the DCRI's Uptal Patel, MD, and colleagues with the National Kidney Disease Education Program's Health Information Technology Working Group outlined specific design features and goals for incorporating data related to chronic kidney disease into EHRs. For example, systolic and diastolic blood pressure should be stored in separate fields, rather than in a single field separated by a slash. The researchers also recommend storing data in formats that can be easily accessed by patients and clinicians. EHRs could also be used to develop chronic kidney disease registries so that clinicians can manage panels of patients and coordinate care with other specialties.

Several characteristics make chronic kidney disease an ideal model for identifying and evaluating methods for more effectively designing and using EHRs to allow clinicians to better care for patients with chronic conditions.

"Chronic kidney disease is common and its care is suboptimal, allowing significant room to show improvement as EHRs are optimized, and because chronic kidney disease is defined by objective data, the disease is an ideal example of a condition that can be easily identified by information commonly found in EHRs," said Dr. Patel, who is chair of the working group. "Chronic kidney disease care also requires collaboration between diverse professionals across numerous healthcare settings, which could be facilitated by EHRs."

The National Institute of Diabetes and Digestive and Kidney Diseases will convene stakeholders in chronic kidney disease health information technology, population health management, and public health research in the fall of 2015 to begin to identify specific solutions for the recommendations included in this article.