Nalini Valluru1, Le Kang2, Jill K J Gaidos3,4. 1. Division of Gastroenterology and Hepatology, Virginia Commonwealth University, PO Box 980341, Richmond, VA, 23298-0341, USA. 2. Division of Biostatistics, Virginia Commonwealth University, PO Box 980032, Richmond, VA, 23298, USA. 3. Division of Gastroenterology and Hepatology, Virginia Commonwealth University, PO Box 980341, Richmond, VA, 23298-0341, USA. Jill.Gaidos@va.gov. 4. Hunter Holmes McGuire VA Medical Center, GI Hepatology Service (111-N), 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA. Jill.Gaidos@va.gov.
Abstract
BACKGROUND: Inflammatory bowel diseases (IBD) and the therapies used to treat these conditions can lead to preventable complications. In 2011, AGA developed the Adult IBD Physician Performance Measures Set to improve accountability and performance management in IBD care; however, compliance remains poor. AIM: The aim of this study is to assess for an improvement in provider compliance with the recommended outpatient preventive care measures in our VA IBD patients after July 2014 following the implementation of a health maintenance template in the Computerized Patient Record system (CPRS). METHODS: We conducted a single-center, retrospective chart review of 139 IBD patients with at least one visit before and after the implementation of the health maintenance template through November 2016. We collected demographic data, immunosuppressive medication use, and recommendations for preventive care. For each variable analyzed, we included those patients where the preventive care measure was indicated based on age, gender, and/or medication use. The McNemar's test for paired nominal data was used to assess the significant difference in recommendation rate, pre- versus post-template implementation. A p value of < 0.05 was considered significant. RESULTS: We included 139 patients (46% with Crohn's disease, 53% with ulcerative colitis, 1% with indeterminate colitis) in the analysis. Seventy-eight (56%) patients were on immunosuppressants. All preventive care measures significantly improved after implementation of the CPRS template except for HPV vaccination. CONCLUSIONS: Implementing a health maintenance template in outpatient GI clinic notes significantly improved provider documentation of the recommended outpatient preventive care in our VA IBD population.
BACKGROUND:Inflammatory bowel diseases (IBD) and the therapies used to treat these conditions can lead to preventable complications. In 2011, AGA developed the Adult IBD Physician Performance Measures Set to improve accountability and performance management in IBD care; however, compliance remains poor. AIM: The aim of this study is to assess for an improvement in provider compliance with the recommended outpatient preventive care measures in our VA IBD patients after July 2014 following the implementation of a health maintenance template in the Computerized Patient Record system (CPRS). METHODS: We conducted a single-center, retrospective chart review of 139 IBD patients with at least one visit before and after the implementation of the health maintenance template through November 2016. We collected demographic data, immunosuppressive medication use, and recommendations for preventive care. For each variable analyzed, we included those patients where the preventive care measure was indicated based on age, gender, and/or medication use. The McNemar's test for paired nominal data was used to assess the significant difference in recommendation rate, pre- versus post-template implementation. A p value of < 0.05 was considered significant. RESULTS: We included 139 patients (46% with Crohn's disease, 53% with ulcerative colitis, 1% with indeterminate colitis) in the analysis. Seventy-eight (56%) patients were on immunosuppressants. All preventive care measures significantly improved after implementation of the CPRS template except for HPV vaccination. CONCLUSIONS: Implementing a health maintenance template in outpatient GI clinic notes significantly improved provider documentation of the recommended outpatient preventive care in our VA IBD population.
Authors: Siddhartha Parker; Laura Chambers White; Chad Spangler; Jessica Rosenblum; Shannon Sweeney; Emily Homan; Steven P Bensen; L Campbell Levy; Maria Conception C Dragnev; Kristen Moskalenko-Locke; Pamela Rich; Corey A Siegel Journal: Inflamm Bowel Dis Date: 2013-08 Impact factor: 5.325
Authors: Michael D Kappelman; Sheryl L Rifas-Shiman; Ken Kleinman; Dan Ollendorf; Athos Bousvaros; Richard J Grand; Jonathan A Finkelstein Journal: Clin Gastroenterol Hepatol Date: 2007-09-29 Impact factor: 11.382
Authors: Joseph D Feuerstein; Natalia E Castillo; Sana S Siddique; Jeffrey J Lewandowski; Kathy Geissler; Manuel Martinez-Vazquez; Chandrashekhar Thukral; Daniel A Leffler; Adam S Cheifetz Journal: Clin Gastroenterol Hepatol Date: 2015-10-20 Impact factor: 11.382