Electronic Data Systems and Acute Kidney Injury.

Abstract

Acute kidney injury (AKI) is a serious condition that is associated with an increased risk of death, long hospital stays, and high healthcare costs. The best chance of ameliorating the severity of AKI and improving its outcomes is through early recognition and intervention. Electronic health records (EHRs) have now become an integrated part of medical practice in most clinical settings worldwide. Appropriate use of EHRs potentially improves patient care, while poorly designed EHRs could result in unintended consequences. In recent years, EHRs with rule-based algorithms have been used for prompt AKI detection. Although studies using these systems have consistently shown that these EHRs have the capacity to improve the detection of AKI, their application in clinical practice to improve outcomes has shown conflicting results. Future use of EHRs for AKI should go beyond rule-based AKI detection to the creation of AKI-forecasting models for early identification of patients at high risk for AKI and the provision of clinical decision support systems to improve the quality of care and outcomes. Despite significant progress in the field of medical informatics and the growing use of EHRs to enhance the quality of care for AKI patients, these domains remain in the very early stages of development. In this chapter, we review the progress made in this field, as well as the methodologies, applications, and outcomes of using EHRs with AKI alerts. We also discuss the directions that EHR tools need to take to improve the care of patients with AKI.