QT-prolonging medication now has score, recent QTc interval

Upgrades in Epic help you recognize risks

Most medications that have a reasonable probability of prolonging the QT interval have received an upgrade in Epic. You’ll now see a score indicating the risk of QTc prolongation as well as the most recent QTc interval from a 12-lead EKG on the ordering screen:

Tisdale score

On the left side of screen, the QT Prolongation Risk Factors shows the Tisdale score. You can find a reference prepared for pharmacy and what to do about it in more detail here, it’s also linked in orders that have a potential to prolong the QTc interval. In short, patients with a Tisdale score between 7 and 10 have about a 37% risk of developing a QTc interval greater than 500 during their stay, and patients with a Tisdale score greater than 11 have a 73% chance of developing a QTc greater than 500. Although the score is not perfect, it beats the “nothing” we have been able to provide when entering orders before.

Most recent QTc interval

The most recent QTc from a 12-lead EKG can be found in the main body of the order entry screen. Unfortunately, it won’t populate the info from rhythm strips.

With these two items, you’ll be equipped to know the QT prolonging risk of a patient and recognize if you might be increasing that risk with medications you are ordering for them.

Questions?

Email Matthew Tanner or call 503-814-9960.