Poster Topical Area: Nutritional Epidemiology

Location: Hall D

Poster Board Number: 757

P20-028 - How Federal Agencies Capture Use of Dietary Supplements in Electronic Medical Records (EMR)

Monday, Jun 11
8:00 AM – 3:00 PM

Objectives: Of importance to federal agencies that administer health care facilities is capturing patient use of dietary supplements (DS) to avoid potential drug – supplement interactions. A survey was conducted to determine how information on DS is being collected, recorded, and processed in EMR across federal agencies.

Methods: Four federal agencies providing direct health care services to large numbers of men and women in the US were surveyed on current practices regarding the recording and processing of information on DS use either on outpatient or inpatient basis. A point of contact for each of the following federal agencies was identified, and a 14 question survey was sent to each for completion: NIH Clinical Center, Department of Defense (DoD) Military Nutrition Committee, Veterans Health Administration (VHA) Office of Specialty Care Services, and the Indian Health Service (IHS), Office of Information Technology. The survey requested database specific information, as well as specific questions regarding linkage of the EMR to the pharmacy.

All four agency representatives completed the survey. No agency used the same EMR software reporting system. Most EMR have searchable fields that are in a structured format, but some information is free text and allowed entry by multiple members of the health-care team. Three different medication formulary or drug knowledge databases were utilized across the agencies. In some EMRs, DS were cross-referenced with medications in structured fields and were free text in others. How DS medications interactions were flagged, as well as the individual responsible for coding interactions varied across the agencies based on the EMR in use.

Most agencies using EMR management systems have adequately described procedures for entering and charting information on DS. The responsibility for charting, however, varies across agencies whether captured by the admitting doctor, nurse, dietitian, or pharmacist. Direct linkage between the pharmacy system and the drug knowledge database is a feature of the EMR for the NIH Clinical Center, the VHA, and the IHS but not across DoD at this time. Establishing common EMR practices could facilitate monitoring the use and potential interactions of DS with prescribed drugs.

Funding Source: Funding Support: NIH Office of Dietary Supplements

CoAuthors: Patricia Deuster, PhD, MPH, FACSM – Uniformed Services University of the Health Sciences; Madeline Michael, CAPT, US Public Health Service, MPH, RD – NIH Clinical Center; Anne Utech, PhD, RDN, LD – Veterans Administration Central Office; Christopher Lamer, CAPT US Public Health Service, PharmD, BCPS, MHS, CDE – Indian Health Service

Rebecca B. Costello

Scientific Consultant
NIH Office of Dietary Supplements
Bethesda, Maryland