Rheumatoid Arthritis Learning Collaborative

Transcription

1 Add your company logo Add here your company logo here Rheumatoid Arthritis Learning Collaborative Sponsored by AMGF and AbbVie June 11, 2015 Group Update Sutter Medical Group of the Redwoods/Sutter Pacific Medical Foundation BENCHMARKING IN EPIC USING RAPID 3 TO ASSESS PATIENTS WITH RHEUMATOID ARTHRITIS

2 Since we last spoke Initially, we gave the Rapid 3 questionnaire to only RA patients at check in to the clinic, as identified by dx listed on schedule day prior to appointment. After review of 1 st quarter results, a program of every patient, every time was started, and all patients coming to Rheumatology are given a Rapid 3. Staff are happy with improved work flow

3 Entry of Data Rapid 3 results were manually tabulated from August through December January 1 st, IT was able to create a space in EPIC for Rapid 3 to be entered under Vitals by MA at time of patient rooming. This allows data to be electronically retrieved through an EMR search

4 Period RA patients results Therapy % Disease Assessment % 7/1/2013 6/30/14 10/1/13-9/30/14 1/1/ /31/14 4/1/14-3/31/15 7/1/14-6/30/15 10/1/14-9/30/15 Patients # on DMARD % Encounters questionnaires % % % 1, % % 1, % % %

5 Clinical Use of Rapid 3 As of January 1 st 2015, Using Rheumatology synopsis we are able to track Rapid 3 scores in tandem with other measures such as lab and medication doses This allows the patient s assessment of their status to be part of the clinical decision making process.

6 Flowsheet entry within vitals

7 Synopsis view within New Rheumatology Profile to include Rapid3 activity

8 Graph of Rapid3 with Labs/Meds

9 New Ideas The patients who are not on DMARDs will be further evaluated with direct chart pulls. Physicians would like to use a diagnostic modifier to indicate DMARD contraindicated or DMARD refused as well as remove Rheumatoid arthritis diagnosis from EPIC if appropriate.

10 Outcomes We have been able to incorporate the first Rheumatology clinic-wide benchmarking project within Sutter Medical Group We have been able to obtain patient buy-in and staff acceptance of the project Without noting any significant delay in clinic flow.

11 Celebrating Accomplishments We have had our first Data release party with staff as well as physicians, management and the medical group President, Director of Quality and Clinic Manager. Awards given to Medical Assistants and IT associate to recognize their work. Open forum held regarding methods to decrease Form Fatigue in our patients and educational opportunities

12 Improvement Interventions Every Patient Every Visit this is your opportunity to let the doctors know how you are doing Forms in English and Spanish

13 Challenges? High Staff Turnover Patients who require additional time to complete questionnaire Upcoming Clinic Move Limited Resources for ongoing project But overall, this has been a fairly streamlined project with minimal disruption to clinic flow that has provided us with additional information on practice size and variation between physicians (minimal).

14 Next Steps We may undertake a random selection of patients who are not on DMARDs to assess accuracy of diagnosis. We are looking for information on V-codes to indicate patients in whom DMARDs are contraindicated or who refuse conventional DMARDs This may make our %patients on DMARDs more accurate. Software builds in future may involve features needed to efficiently document Das -28 and other benchmarking tools.

15 Lessons Learned It s all about the team Because IT changes to EPIC were system wide, we may begin system-wide education of all 22 Sutter Rheumatologists about using the Rapid 3 and DMARD use as benchmarking tool with EPIC.

16 Questions We are looking for Diagnostic modifiers to notate charts where DMARDs are refused or contraindicated. Does anyone else use them?