Amiodarone is a powerful medication commonly used for treating cardiac rhythm disorders such as atrial fibrillation. While highly effective, if prescribed improperly it can have serious side effects.
“Amiodarone is a toxic medication when used outside the prescribing guidelines, and we felt there was a safety gap that we could address with a technology and workflow solution,” says Jitesh Vasadia, MD, who spearheaded the Amiodarone Monitoring Program.
Working with the KP chiefs of cardiology, Division of Research, and TPMG Consulting Services, Dr. Vasadia developed a workbench tool in the electronic medical record that automatically imports all patients taking amiodarone, creates alerts for missing and abnormal tests, and tracks quality metrics. A pharmacist led medical assistant uses the workbench tool to monitor all patients taking amiodarone twice annually.
“Dr. Vasadia understood that to launch a successful program, he would need to pull on resources from many distinct parts of our integrated health care organization,” says Brian Missett, MD, TPMG associate executive director. “He did this extremely efficiently to create a model program for the patients.”
“People enjoyed the work they did, and within 4 months we had a very robust process that could be tracked to show efficiency and success,” Dr. Vasadia says.
After the Amiodarone Monitoring Program was launched at 12 KP medical centers, compliance for recommended biannual laboratory monitoring jumped from 30–40% to upwards of 80%. Likewise, the program halted inappropriate prescribing, reducing associated risks to patients. Plans are now underway to extend the program to all KP medical centers and other arhythmic medications.
“Across the region, more than 200 cardiologists are extremely grateful to Dr. Vasadia,” says Howard Dinh, MD, KP Northern California chair of cardiology chiefs. “In this day and age of physician burnout, he was able to centralize the process, allowing us to take care of more urgent issues and loop us in when our expertise is really needed.”