Using EMR to improve compliance with clinical practice guidelines for management of stable COPD

Jordan Terasaki, Gurinder Singh, Wei Zhang, Penny Wagner, Gulshan Sharma

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Clinical practice guidelines are underutilized in the outpatient management of chronic obstructive pulmonary disease (COPD). We hypothesize that a structured approach using the electronic medical record (EMR) will improve compliance with clinical practice guidelines for the evaluation and management of patients with stable COPD. Methods Clinical records were evaluated in a pre- and post-intervention analysis of patients with COPD seen in our pulmonary clinics at a single tertiary care academic setting. Patient charts were retrospectively screened for the diagnosis of COPD and individually assessed for a diagnosis of COPD by spirometry. We then developed and implemented a COPD Flowsheet based on clinical practice guidelines into each outpatient clinic encounter for COPD with repeat chart review of clinic patients. Improvement in the pre- to post-intervention quality metrics were compared using t-test and Chi squared as indicated. A p-value of 1/FVC <0.70, respectively. There was a significant increase in the use of severity assessment by BODE index (13.2% vs 32.2%, p-value <0.001), inhaler technique teaching (35.4% vs 65.2%, p-value <0.001), osteoporosis screening (20.8% vs 44.9%, p-value <0.001) and influenza vaccination (74.3% vs 83.5%, p-value = 0.03) in post intervention period. Conclusions Implementation of a standardized COPD Flowsheet developed from clinical practice guidelines improves advanced assessment of patients with COPD and other quality of care measures.

Original languageEnglish (US)
Pages (from-to)1423-1429
Number of pages7
JournalRespiratory Medicine
Volume109
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Electronic Health Records
Practice Management
Practice Guidelines
Chronic Obstructive Pulmonary Disease
Quality of Health Care
Nebulizers and Vaporizers
Spirometry
Tertiary Healthcare
Ambulatory Care Facilities
Human Influenza
Osteoporosis
Teaching
Vaccination
Outpatients
Lung

Keywords

  • COPD clinical practice guidelines
  • COPD management
  • EMR electronic medical records
  • Outpatient COPD

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Using EMR to improve compliance with clinical practice guidelines for management of stable COPD. / Terasaki, Jordan; Singh, Gurinder; Zhang, Wei; Wagner, Penny; Sharma, Gulshan.

In: Respiratory Medicine, Vol. 109, No. 11, 01.11.2015, p. 1423-1429.

Research output: Contribution to journalArticle

Terasaki, Jordan ; Singh, Gurinder ; Zhang, Wei ; Wagner, Penny ; Sharma, Gulshan. / Using EMR to improve compliance with clinical practice guidelines for management of stable COPD. In: Respiratory Medicine. 2015 ; Vol. 109, No. 11. pp. 1423-1429.
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