Abstract: Slide Presentations |


Cynthia Gronkiewicz, APN*; Marilyn Borkgren-Okonek, APN; Edward Diamond, MD; Patti L. Hickam, RHIT
Author and Funding Information

Suburban Lung Associates, Elk Grove Village, IL


Chest. 2009;136(4_MeetingAbstracts):63S. doi:10.1378/chest.136.4_MeetingAbstracts.63S-f
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PURPOSE:  To develop disease-specific EMR templates for outpatient COPD management to promote compliance with evidence-based guidelines and to facilitate organized performance measurements.

METHODS:  This abstract describes the initial phase of a multiphase EMR implementation project for COPD at a large suburban pulmonary/allergy/sleep/critical care medicine practice. Fifteen providers conducted 28,484 outpatient COPD visits at three sites during the 14-month pre-implementation period. Four templates were developed by APNs and MDs over 6 months. Technology consultants facilitated integration of developed content into the existing EMR framework. Two COPD templates were created for consult/initial visit and follow-up/exacerbation visit. Key elements of the GOLD recommendations for patient evaluation utilizing narrative text and validated tools (MMRC, CCQ) were grouped into 8 domains: symptoms, cough, dyspnea, exposure/acuity, oxygen usage, activity level, quality of life, and COPD severity level based on spirometry. Two APN patient education and exercise templates were created to address GOLD recommendations for improving health education and functional status. The education templates and corresponding patient handouts address thirteen topic areas: correct medication and oxygen use, quality of life (sleep, nutrition, mood), activity level (exercise plan), and self-management (recognition of exacerbation, energy conservation). An exercise template was designed for patients not enrolled in formal pulmonary rehabilitation. This individualized plan of strengthening and aerobic exercises is based on each patient's dynamic health status and revised on an ongoing basis. The four templates were placed in a test mode for one month for provider feedback prior to clinical implementation.

RESULTS:  1. Four COPD templates provide a standardized framework for practice-wide implementation of GOLD guidelines in evaluation and management of COPD outpatients. 2. EMR documentation yields an ongoing and organized record of clinical assessment, COPD severity level, health education, and functional status.

CONCLUSION:  COPD templates provide a comprehensive, individualized, and organized assessment tool based on GOLD guidelines.

CLINICAL IMPLICATIONS:  1. Electronic data search and analysis will facilitate performance measurement to improve clinical management and patient outcomes. 2. Data captured support future focus on automated processes to enhance clinical decision making.

DISCLOSURE:  Cynthia Gronkiewicz, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

2:15 PM - 3:15 PM




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