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Rural Elderly Patients Will Benefit From Grant to Develop Master Medication List

   Portland, Ore.

Elderly rural patients on multiple medications just got a boost in their health safety thanks to a $1.5 million, three-year matching grant to Samaritan North Lincoln Hospital in Lincoln City. Samaritan will partner with multiple departments of Oregon Health & Science University, including Oregon Rural Practice-based Research Network (ORPRN), as well as Portland State University to address medication safety for elderly residents in Lincoln County. It is then hoped that this project can be duplicated in other rural areas throughout the country.

The new grant is from the Agency for Healthcare Research and Quality, (AHRQ), the health services research arm of the U.S. Department of Health and Human Services and is part of $139 million in grants and contracts to promote the use of health information technology. This multi-year program builds on a federal initiative to improve the nation's health care system.

"It's most important in an elderly care setting that drugs, which are so helpful but at the same time can be so harmful, are kept track of properly. This funding will create a community-wide master medication list for patients in elder care facilities in north Lincoln County. It will benefit patients and will decrease frustration among their caregivers. It could revolutionize the way we track use of medications in a population that typically has difficulty with that task," said Karl Ordelheide, M.D., co-principal investigator for Samaritan North Lincoln Hospital and the hospital's medical director of outpatient information systems, and a member of the steering committee for ORPRN. Samaritan is the lead partner for the project.

"What's exciting about this project is the unique collaboration of so many different organizations to produce something that really benefits Oregonians," said Paul Gorman, M.D., co-principal investigator of the study and an associate professor of medical informatics and clinical epidemiology, OHSU School of Medicine. To solve a problem that no one of us could tackle on our own, we have assembled a consortium of public and private health care providers who have support from local community organizations and technical expertise from OHSU Oregon Rural Practice-based Research Network. In the end, I think everybody benefits."

This project aims to fix the potential for medication errors, which increases when multiple facilities take care of a patient, and each facility has a different medication tracking system, said L.J. Fagnan, M.D., director of the ORPRN, associate professor of family medicine, OHSU School of Medicine.

"For example, let's say a patient takes multiple medications. She's in a nursing home and she breaks her hip. She is then transferred to the hospital for treatment and is given additional medications, which are written on her hospital chart. She then sees a specialist in private practice who adds to these medications, again recording it on a stand-alone chart. Then she is transferred back to the nursing home. Despite the best paper systems in place at each of these facilities and the transfer of orders between facilities, pretty soon nobody is sure what medications she should be taking. This grant will allow us to coordinate and get all the information on a computerized system so any health professional can click on it and get up-to-date information. State-of-the art techniques for data mining will enable the system to detect problems such as inappropriate doses before they can cause serious incidents. We're using technology to create the electronic shoebox of medications," Fagnan said.

A large portion of the $1.5 million matching funds will come from the Oregon Opportunity a statewide $500 million public/private partnership to make Oregon a national leader in medical research. Oregon voters overwhelmingly approved $200 million in public funds to support the effort and OHSU is close to completing its $300 million portion through private donations. Substantial matching funds are also coming from each of the partners in the study, which include Samaritan North Lincoln Hospital, several departments at OHSU, as well as multiple community participants: Lincoln City Medical Center, Bayshore Medical Center, Pacific City, Hillside House Assisted Living Facility, Lincoln City, Lincoln City Rehabilitation, Lincolnshire Retirement & Assisted Living, Lincoln City, Senior Pharmacy, Preferred Pharmacy Lincoln City pharmacies in Safeway, BiMart and RiteAid and the Community Health Improvement Partnership in Lincoln County, which serves as a community advisory board for the study,.

Departments and schools at OHSU participating in the study include the Department of Medical Informatics and Clinical Epidemiology, the OGI School of Science & Engineering, the School of Nursing, the Department of Family Medicine as well as the Oregon State University College of Pharmacy.

The mission of the Oregon Rural Practice-based Research Network is to improve the health of rural populations in Oregon through conducting and promoting health research in partnerships with the communities and their practitioners.

The network currently is working with 28 physicians' offices located in 23 rural Oregon communities. The practices include 120 primary care clinicians who provide care for more than 130,000 patients. Current network research projects include studies on children's health, immunization, osteoporosis, work flow of rural practices, and opioid prescribing and preventive care. Studies related to literacy in primary care, behavioral health, obesity, colorectal cancer screening and health behavior interventions are in development. The network has researchers and research coordinators located throughout the state of Oregon.

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