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NKDEP Working Group urges better electronic health record-keeping to improve chronic kidney disease outcomes

Improving electronic health records (EHRs) and standardizing their use could help improve care for people with chronic kidney disease (CKD), according to goals described by the National Kidney Disease Education Program’s (NKDEP) Health Information Technology (HIT) Working Group in a paper published in the Clinical Journal of the American Society of Nephrology.

Current designs and practices for EHRs limit their potential to improve care for and research into those with chronic diseases. However, if healthcare providers input data in specific formats and use standard code systems and units, that consistency could help make EHRs more useful for tracking CKD over time. More than 20 million American adults may have CKD, and the risk increases with age.

“Improving interoperability to optimize CKD detection and management could enhance CKD surveillance, clinical care, and research,” said NKDEP Director Andrew Narva, M.D., a senior author on the report.

CKD is diagnosed and monitored using lab tests to assess kidney function—including serum creatinine and corresponding estimated glomerular filtration rate (eGFR)—and kidney damage, which is assessed by measuring urine albumin-to-creatinine ratio. By uniformly including the results of these tests and other results in EHRs, providers can better ensure that people with CKD get appropriate and consistent care and that tests need not be repeated because the information is missing.

Currently, the ability to securely exchange such data between healthcare providers is limited. Making the data sharable —while preserving patient privacy—can improve continuity of care and may also reduce costs. Healthcare providers could use EHRs to search for patients with CKD, enabling them to create CKD registries. They could also track quality of care, and more easily coordinate care with other specialists. Also, providers can search EHRs to locate patients who need more attention, such as those whose blood pressure is not adequately controlled.

The report emphasizes the importance of standardizing how blood pressure and other measurements are put into EHRs. Taking such steps may result in improved care because researchers can develop best practices based on data from a broad group of patients.

Paul Drawz, M.D., of the University of Minnesota, a member of the NKDEP Health Information Technology Working Group, was the lead author. The group includes national HIT experts, as well as staff from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Library of Medicine, both components of NIH, as well as the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and the Food and Drug Administration.

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