How Electronic Health Records Are Improving Health Care for Elderly Patients: Innovative Information Technology Tools Help Ensure Patients Get the Right Care at the Right Time

Article excerpt

Older adults account for more than one-third of acute-care hospitalizations and 58% of hospital days in Ontario, Canada. Leaders and staff at Mount Sinai Hospital in Toronto, Ontario, recognized that the current hospital system was designed to meet the needs of a younger population, not frail older adults. To better address the needs of frail older adults, the hospital sought to develop programs and tools that would help caregivers deliver the right care in the right place at the right time.

Acute Care for Elders strategy

Mount Sinai was able to seamlessly implement and enhance its Acute Care for Elders (ACE) strategy with its frontline clinicians and informatics department, in part because Cerner Millennium[R] was already established as the hospital's electronic health record (EHR) platform. The informatics department staff met frequently with frontline caregivers to understand their needs and the care they sought to provide.

Key components of the ACE strategy include six evidence based admission order sets (the general ACE unit order set and sets for older patients with chronic obstructive pulmonary disease, heart failure, cellulitis, pneumonia, and hip fractures). The ACE superset contains several admission order sets and ensures ACE-specific protocols are used in the care of every older patient. They also ensure patients receive optimal medications and care proto cols as quickly as possible so that consultations with specialists and allied health providers can begin much earlier.

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ACE also integrates documentation of key geriatric clinical process and outcomes indicators into Mount Sinai's existing clinical documentation tools. These indicators populate the vital signs section of the health record to better support the care of frail elderly patients and help monitor the overall quality of care being delivered. …