title: The "epic" challenge of optimizing antimicrobial stewardship: the role of electronic medical records and technology.
abstract: Antimicrobial stewardship programs (ASPs) are established means for institutions to improve patient outcomes while reducing the emergence of resistant bacteria. With the increased adoption and evolution of electronic medical records (EMRs), there is a need to assimilate the tools of ASPs into EMRs, using decision support and feedback. Third-party software vendors provide the mainstay for integration of individual institutional EMR and ASP efforts. Epic is the leading implementer of EMR technology in the United States. A collaboration of physicians and pharmacists are working closely with Epic to provide a more comprehensive platform of ASP tools that may be institutionally individualized. We review the historical relationship between ASPs and the EMR, cite examples of Epic stewardship tools from 3 academic medical centers' ASPs, discuss limitations of these Epic tools, and conclude with the current process in evolution to integrate ASP tools and decision support capacities directly into Epic's EMR.
authors.affiliation: College of Pharmacy, Oregon State University/Oregon Health & Science University, Portland.
authors.forename: Ravina
authors.initials: R
authors.lastname: Kullar
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goff
authors.forename: Lucas T
authors.initials: LT
authors.lastname: Schulz
authors.forename: Barry C
authors.initials: BC
authors.lastname: Fox
authors.forename: Warren E
authors.initials: WE
authors.lastname: Rose
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D020000:Decision Support Systems, Clinical; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D004363:Drug Utilization / Q000592:standards*; D057286:Electronic Health Records; D006295:Health Resources; D006801:Humans; D008490:Medical Informatics; D012984:Software; D014584:User-Computer Interface
chemical_list: D000900:Anti-Bacterial Agents
keywords: Epic; antimicrobial stewardship; electronic medical records; technology