Clinical practice guidelines embedded in electronic health records improve providers' evaluation and management of patients with stable chronic obstructive pulmonary disorder (COPD), according to a recent article in Respiratory Medicine.
The researchers, from the University of Texas Medical Branch (UTMB) at Galveston, developed and used an evidence-driven COPD flowsheet based on clinical practice guidelines; the guidelines popped up on the screen to prompt the provider. The flowsheet was tested at pulmonary clinics in a tertiary care academic setting; 200 patients were seen pre-intervention and 347 were seen post-intervention.
The researchers reviewed the medical records of the patients and found a "significant" increase in the treatment and monitoring of patients after institution of the flowchart. That included increased use of tools to measure the severity of COPD from the previous visit, more referrals to a pulmonary rehabilitation program, better inhaler technique education, greater use of short acting inhalers and long-term lung medications, among other steps.
"Efficacy trials have shown that guidelines concordant treatment improves outcomes and healthcare utilization," author Gurinder Singh told FierceEMR. "Often in a busy clinical practice, it is difficult for providers to know all the clinical practice guidelines. Easy accessibility with [the] flowsheet will improve compliance with CPGs, which will indirectly reduce healthcare utilization and overall cost."
COPD takes a heavy toll on the healthcare system, since patients suffering from it often end up in the emergency department and admitted to the hospital for treatment.
"Because COPD complications lead to an overall decline in lung function and quality of life, it is important to optimize the outpatient management of these patients," lead author, Jordan Terasaki, UTMB fellow in the department of internal medicine, said in a statement. "Timely access to care or an action plan can avoid emergency room visits and/or hospitalizations in these patients."
Many studies have shown that EHRs checklists, alerts and data analytics can help identify high risk patients and improve patient care. Improving patient safety has been one of the primary drivers of EHR adoption.