Max Healthcare organises Continued Medical Education in Delhi

Effective application of Electronic Health Records at Max Healthcare helps resolve the problem of DVT prevention

January 22, 2014 5:16 IST | India Infoline News Service
Max Healthcare - leading healthcare services provider of Delhi today organized a CME (Continued Medical Education) on the theme ‘VTE Prophylaxis’ at Hotel Sheraton, Saket. The CME was conducted by the Department of Clinical Data Analysis (CDA) at Max Healthcare and highlighted the issue of prevention against Deep Vein Thrombosis which is many a time neglected in admitted patients globally and in India.
Commonly known as the ‘Economy Class Disease’, DVT can happen to anyone and everyone- from a patient with a broken leg to one admitted in the ICU to someone who has cancer to as common as someone travelling in a 15 hours flight. Yet, it remains to be one of the most underdiagnosed diseases in the world.
DVT happens due to blood clot formation in a deep vein. It is most common in the deep veins of one’s lower leg (calf), and can spread up to the veins in one’s thigh. Deep veins pass through the centre of the leg and are surrounded by a layer of muscle. When blood clots form in the superficial veins, which lie just under the skin, the condition is known as superficial thrombophlebitis. These superficial blood clots are different from DVT and are less severe. Many blood clots that cause DVT are small and don't produce any symptoms. One’s body will usually be able to gradually break them down with no long-term effects. If the clot breaks down, it can travel up to the lungs and even lead to death.
Max Healthcare sees Electronic Health Records (EHR) as the game changer in the prevention of DVT in patients. The underdog of health problems, DVT prevention often goes unnoticed in patients and doesn’t play a high role in doctor’s priority list when a patient is admitted with more acute medical problems. Clinical decision support system (CDSS), part of the Electronic Health Record system at Max Healthcare, empowers the clinician with intelligent order checks, notifications and clinical reminders. Thus, for every patient admitted in the hospital, a notification is sent to the concerned doctor to check for risk factors for the development of DVT. If for any reason, the notification isn’t resolved by the health expert within 24 hours, a reminder is sent to his smartphone to check his patient for risk factors for DVT. In addition, the nurses are empowered to put a pump temporarily on the patient’s leg if the DVT notification hasn’t been answered by the doctor within 24 hours. This helps keep DVT at bay during the hospital stay of the patient.
The potential of EHR for improving quality and safety has been accepted worldwide, and most countries have started implementing computerized medical record systems in their hospitals, both at government and private sector level. Implementation requires a significant change in culture and habits, integration with the human aspects of the doctor /nurse-patient interface, and the high level of commitment to change - which can be overwhelming and daunting, but the industry is gradually accepting that this transformation is inevitable.
Dr Sandeep Budhiraja, Director, Internal Medicine and CDA educated the audience about the overview of the issue of DVT and the advantage of EHR. He shared, “There are primarily two main reasons why DVT prevention does not rank as a high priority among physicians - Firstly, a doctor under-estimates the risk of his patient developing DVT. Secondly, he sometimes over-estimates the risk of blood thinners. However, if a patient is at risk of DVT, small dosage of blood thinner is absolutely fine and safe, unless there are certain medical reasons of not using them. With the introduction of EHR technology, we have been able to generate alerts which pop up on the computer screens or smart phone screens of doctors and ensure that they take preventive measures in advance. EHR  has a complete clinical decision support protocol for risk assessment of a patient developing DVT and guides a physician through very simple 3-steps to initiate preventive blood thinners where indicated. We aim to prompt each doctor to check his or her patient of DVT- low, moderate or high risk- and help make Max Healthcare a DVT free hospital.”
DVT is also more likely to occur when the blood flow through the deep veins is slowed. Immobility is one such factor; blood flow is slowed when a person remains immobile for long periods of time. Incidents like paralysis (following a stroke or injury); being bedridden (following a surgery due to illness); having a leg in a plaster cast or splint or; even sitting for long periods of time while travelling – in a bus, car or plane- can result in DVT. Since DVT can occur without any obvious symptoms, diagnosis can sometimes be difficult. EHR alerts would help physicians decide as to which patients should be given DVT prevention treatment, and hence, be able to prevent DVT and DVT related pulmonary embolism, a preventable fatal condition.

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