AI&DHI Researcher Spotlight - Dr. Geoff Barnes

Written By Kate Murphy

Our Researcher Spotlight focuses on Dr. Geoff Barnes, Associate Professor of Internal Medicine, Medical School. Dr. Barnes’ digital health research focuses on using electronic health record tools to improve the safe care of patients taking anticoagulant medications. His team recently completed a trial where clinicians were randomized to receive Epic notifications directly or have them sent to a clinical pharmacy specialist when one of their patients had an off label oral anticoagulant prescription. The goal of the study was to compare the responsiveness of prescribing clinicians and clinical pharmacy specialists to each of these notifications.

Also recently completed was an analysis of the nation-wide VA implementation of a population health dashboard used by clinical pharmacists to monitor oral anticoagulant prescribing and intervene when off label prescriptions were being used; Dr. Barnes and team took this model from the VA and translated it to the non-VA setting, building a similar population health dashboard within the Epic electronic health record and a parallel dashboard that uses FHIR interoperability standard to interact with any major EHR platform. These tools are currently being used in five health systems nation-wide.

Dr. Barnes says that this research is particularly innovative for a few reasons;

“First, we’re finding new ways to engage clinical pharmacy specialists into the long-term care of patients prescribed medications. Pharmacists have deep expertise in medication management and are an amazingly effective resource for prescribing clinicians, patients, and their caregivers.  Second, we’re using the EHR to directly randomize clinicians to different intervention states in real time – this novel approach reduces administrative burden and allows for a better balance of the randomized groups. Third, we’re taking a detailed user-centered design approach to developing, implementing, and evaluating various alerts and notifications built within the EHR. For many clinicians, EHR alerts are burdensome and anxiety-provoking. However, when designed thoughtfully and with ample end-user feedback, these alerts can be quite helpful for clinicians and improve clinical care.”

In aiming to identify specific strategies that can be used within the EHR to improve the same delivery of medications in both the acute care and ambulatory care settings, they rely on robust implementation science evaluation frameworks to guide their outcome assessment. This includes the use of both qualitative and quantitative data capture. Dr. Barnes and team strongly believe that innovative tools built into the EHR along with better partnerships between prescribing clinicians and clinical pharmacists will greatly improve the care that patients experience; they’ve demonstrated that these tools and partnerships can help improve safe medication prescribing, which is directly associated with a reduction in life-threatening stroke and pulmonary embolism events. They have also found a high level of satisfaction with the EHR alerts and notifications from their front-line clinicians; alerts designed and implemented by the team are extensively revised with end-user feedback and are routinely appreciated by clinicians. All of this helps to demonstrate the immense value of the clinician-pharmacist partnership for both acute and chronic medication management.

Many of this team’s interventions have been adopted nation-wide, including some of the earliest examples of Antithrombotic Stewardship - a care model rapidly being adopted nation-wide to address the public health crisis of adverse drug events related to off-label and unnecessary use of antithrombotic agents, including anticoagulants and antiplatelet medications. An EHR-based intervention leveraging nurses in their anticoagulation clinic to assist with aspirin de-prescribing for patients already taking oral anticoagulation has been broadly adopted nation-wide through coordinated efforts of the Anticoagulation Forum.

When Dr. Barnes isn’t working on antithrombotic stewardship efforts or designing new EHR interventions, he loves spending time with his family (husband, 8 year old daughter, 12 year old dog), traveling, playing board games, skiing, and playing tennis.

 

Recent Publications

Kate Murphy
Previous

The Michigan Genomics Initiative announces the release of genetic Data Freeze 7
Next

Request for Proposals: Genome Sequencing of MGI Participants