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Learning Objective 1: The learner will be able to recognize how utilizing the EMR can lead to an increase in quality measures.
Learning Objective 2: The learner will be able to recognize the importance of leveraging EMR to increase contraceptive documentation in women of reproductive age.
Considering half of all pregnancies in the United States are unintended, it is imperative to consider contraceptive management when prescribing potentially teratogenic medications to women of reproductive age (Moos et al., 2008). Congenital abnormalities are among the leading causes of infant mortality in the United States (Dunlap, Gardiner, Shellhaas, Menard, & McDiarmid, 2008). Ten percent of congenital abnormalities have been associated to a confirmed teratogenic exposure (Eisenburg, Stika, Desai, Baker, & Yost, 2009). Maternal avoidance of teratogenic exposures would minimize congenital abnormalities (Dunlap et al., 2008).
Aim:
To establish a Best Practice Alert (BPA) that utilizes the electronic medical record (EMR) to prompt providers to document contraception in reproductive aged women receiving a teratogenic medication.
Setting:
Adult Primary Care clinics in a large Northern California HMO located in the Central Valley.
Participants:
Women ages 18-49 years old that have received an initial prescription of Category X medication, Ace Inhibitor, or Angiotensin Receptor Blocker.
Methods:
Medical records of 300 women to be reviewed for contraceptive documentation or evidence of referral to Ob/Gyn that resulted in contraceptive documentation within 6 months of the Best Practice Alert being implemented into the EMR.
Expected Outcomes:
Will compare the result of chart review after the implementation of the BPA to the data compiled prior to implementation of the BPA. With the implementation of the BPA, the short-term expectation is that documentation of contraception will increase by 50%. Long-term outcomes would include that there is an overall decrease in the number of pregnancies exposed to teratogenic medications.