title: Development and Implementation of an Electronic Decision Support to Manage the Health of a High-Risk Population: The enhanced Electronic Medical Record Aging Brain Care Software (eMR-ABC).
abstract: BACKGROUND
  Health care systems in the United States are transitioning from volume-based purchasing models to value-based purchasing models that demand both delivery of personalized care for each patient and cost-effective population health management. The enhanced medical record for aging brain care (eMR-ABC) software is an electronic decision support system that facilitates the management of a high-risk population suffering from aging brain disorders such as dementia.
  
  
  METHODS
  Using the lenses of the Complex Adaptive System and the Reflective Adaptive Process, we assembled an interdisciplinary team of clinicians, health services researchers, and software developers who designed, implemented, evaluated, and continuously modified the eMR-ABC to meet the needs of care coordinators who manage the health of a targeted high-risk population.
  
  
  RESULTS
  The eMR-ABC captures and monitors the cognitive, functional, behavioral, and psychological symptoms of a registry of patients suffering from dementia or depression as well as the burden of patients' family caregivers. It provides decision support to care coordinators to create a personalized care plan that includes evidence-based nonpharmacological protocols, self-management handouts, and alerts of medications with potentially adverse cognitive effects. The software's built-in engine tracks patient visits and on-demand functionality to generate population reports for specified indicators.
  
  
  CONCLUSIONS
  Population health programs depend on data collection and information systems with the ability to provide valuable and timely feedback on an ongoing basis. Following these guidelines, the eMR-ABC was designed specifically to meet the management needs of a high-risk population.
authors.affiliation: Indiana University ; Regenstrief Institute.
authors.forename: Amie
authors.initials: A
authors.lastname: Frame
authors.affiliation: Indiana University ; Regenstrief Institute ; Indiana University School of Medicine;
authors.forename: Michael
authors.initials: M
authors.lastname: LaMantia
authors.affiliation: Mavensphere, Inc.
authors.forename: Bharath B
authors.initials: BB
authors.lastname: Reddy Bynagari
authors.affiliation: Regenstrief Institute ; Indiana University School of Medicine; ; Wishard Health Services.
authors.forename: Paul
authors.initials: P
authors.lastname: Dexter
authors.affiliation: Indiana University ; Regenstrief Institute.
authors.forename: Malaz
authors.initials: M
authors.lastname: Boustani
keywords: Indiana PROSPECT; Informatics; decision support; evidence based medicine; health information technology
references.citation: Healthc Inform. 2012 Feb;29(2):26, 28
references.pmid: 22400383
references.citation: J Gen Intern Med. 2006 Feb;21 Suppl 2:S58-64
references.pmid: 16637962
references.citation: JAMA. 2007 Jan 24;297(4):403-6
references.pmid: 17244837
references.citation: J Gen Intern Med. 2006 Feb;21 Suppl 2:S25-9
references.pmid: 16637957
references.citation: J Gen Intern Med. 2012 May;27(5):561-7
references.pmid: 22302355
references.citation: Aging Ment Health. 2011 Jan;15(1):5-12
references.pmid: 20945236
references.citation: Ann Fam Med. 2005 Sep-Oct;3(5):430-5
references.pmid: 16189059
references.citation: Health Care Manage Rev. 2003 Jul-Sep;28(3):266-78
references.pmid: 12940348
references.citation: Clin Interv Aging. 2012;7:143-57
references.pmid: 22791987
references.citation: J Healthc Manag. 2004 May-Jun;49(3):155-68; discussion 169-70
references.pmid: 15190858
references.citation: Clin Interv Aging. 2009;4:225-33
references.pmid: 19554093
references.citation: J Am Geriatr Soc. 2006 Jan;54(1):104-9
references.pmid: 16420205
references.citation: Ann Fam Med. 2006 Mar-Apr;4(2):109-16
references.pmid: 16569713
references.citation: Am J Public Health. 2003 Mar;93(3):380-3
references.pmid: 12604476
references.citation: Clin Interv Aging. 2010 May 25;5:141-8
references.pmid: 20517483
references.citation: Gerontologist. 2004 Aug;44(4):548-53
references.pmid: 15331812
references.citation: JAMA. 2006 May 10;295(18):2148-57
references.pmid: 16684985
references.citation: Qual Health Res. 2005 May;15(5):669-85
references.pmid: 15802542
references.citation: Health Aff (Millwood). 2005 Sep-Oct;24(5):1214-20
references.pmid: 16162565
references.citation: J Am Geriatr Soc. 2010 Apr;58(4):777-82
references.pmid: 20398162
references.citation: J Gen Intern Med. 2005 Jul;20(7):572-7
references.pmid: 16050849
references.citation: Jt Comm J Qual Patient Saf. 2005 Aug;31(8):438-46
references.pmid: 16156191
references.citation: JAMA. 2002 Oct 16;288(15):1909-14
references.pmid: 12377092
references.citation: Ann Intern Med. 2003 Jun 3;138(11):927-37
references.pmid: 12779304
references.citation: N Engl J Med. 2003 Jun 19;348(25):2526-34
references.pmid: 12815139
references.citation: J Gen Intern Med. 2006 Feb;21 Suppl 2:S14-20
references.pmid: 16637955
references.citation: Clin Interv Aging. 2007;2(2):247-53
references.pmid: 18044140
references.citation: J Am Med Inform Assoc. 2009 Sep-Oct;16(5):637-44
references.pmid: 19567796