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Data Collection in Private Practice and Implementation with Electronic Medical Records

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Data Collection in Private Practice and Implementation with Electronic Medical Records ... Practice Benchmarking for the Rheumatologist, ACR and the Health ... – PowerPoint PPT presentation

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Title: Data Collection in Private Practice and Implementation with Electronic Medical Records


1
Data Collection in Private Practice and
Implementation with Electronic Medical Records
  • Martin J Bergman, MD
  • ChiefRheumatology
  • Taylor Hospital
  • Ridley Park, PA

2
Patient Encounters
  • The average Rheumatologist sees
  • 19 encounters/day-- 4 days/wk
  • 3574 patient visits/year

Practice Benchmarking for the Rheumatologist, ACR
and the Health Care Group, August 2003
3
of Office-based Physicians using EMR
CDC-National Center for Health Statistics--2006
4
of Office-based Physicians using EMR
CDC-National Center for Health Statistics--2006
5
Use of Billing Software vs EMR
CDC-National Center for Health Statistics--2006
6
Obstacles to EMR
  • Cost
  • Ranges from 5000 to gt30000
  • Loss of Productivity
  • Steep learning curve
  • Integration into Group Setting
  • Networking
  • Competing practice styles
  • Technophobia

7
Advantages of EMR
  • Decrease in Practice expenses
  • Dictation services and Ancillary staff
  • Increased productivity
  • Elimination of after hours dictation
  • Improved quality of documentation
  • Improved patient care
  • Improved documentation for reimbursement
  • Ability to extract data for personal use

8
Data Collected
  • Demographics
  • Age
  • Sex
  • Employment status
  • Diagnoses
  • Active and Co-morbid
  • Medications
  • Active and Past

9
Data Collected
  • Labs
  • Patient reported measures
  • Pain
  • Patient Global
  • Function (MDHAQ)
  • RAPID
  • Fatigue
  • MD Global
  • Tender and Swollen Joint Counts
  • DAS28

10
Data collection is facilitated through the use of
questionnaires
11
Patient completes questionnaire while waiting for
visit
Patient checks in and is given questionnaire by
the receptionist
Physician eyeballs questionnaire and scores
Results of questionnaire are entered into computer
Standard office visit begins
12
Methods of Entering Data
  • Paper questionnaire
  • Manually entered or scanned
  • Desktop
  • Increase in physical space required
  • PDA
  • Small screen and small size is advantage and
    disadvantage
  • Laptop
  • Cost

13
Entering data into a computer does not decrease
productivity
Computer
Paper
Paper
T Pincus, M Bergman, Y Yazici, J Roth, C
Swearingen Abstract 1764 ACR 2006 Washington DC
14
Uses of Data
  • Extract data for personal use
  • Monitor individual patient responses
  • Monitory practice outcomes
  • Extract for collaborative use
  • Share with existing databases
  • National Data Bank for Rheumatic Diseases
  • CORRONA
  • May require reformatting

15
Graphing of Patient Response
MTX
ADA
16
Practice Statistics
17
Duration of Treatment vs. RAPID
18
DAS28 vs RAPID
19
Summary
  • Private Practioners are a valuable and
    underutilized source of useful clinical data
  • Computerized records can be a means or collecting
    clinical data
  • Low cost
  • Efficient
  • Comprehensive
  • Choice of system is dependent on the needs of the
    practitioner(s)

20
Summary
  • Collected data has multiple uses
  • Monitoring individual patient outcomes
  • Monitoring practice performance
  • Participation in large databases
  • Participation in small, independent research
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