Title: Data Collection in Private Practice and Implementation with Electronic Medical Records
1Data Collection in Private Practice and
Implementation with Electronic Medical Records
- Martin J Bergman, MD
- ChiefRheumatology
- Taylor Hospital
- Ridley Park, PA
2Patient 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
5Use of Billing Software vs EMR
CDC-National Center for Health Statistics--2006
6Obstacles to EMR
- Cost
- Ranges from 5000 to gt30000
- Loss of Productivity
- Steep learning curve
- Integration into Group Setting
- Networking
- Competing practice styles
- Technophobia
7Advantages 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
8Data Collected
- Demographics
- Age
- Sex
- Employment status
- Diagnoses
- Active and Co-morbid
- Medications
- Active and Past
9Data Collected
- Labs
- Patient reported measures
- Pain
- Patient Global
- Function (MDHAQ)
- RAPID
- Fatigue
- MD Global
- Tender and Swollen Joint Counts
- DAS28
10Data collection is facilitated through the use of
questionnaires
11Patient 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
12Methods 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
13Entering 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
14Uses 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
15Graphing of Patient Response
MTX
ADA
16Practice Statistics
17Duration of Treatment vs. RAPID
18DAS28 vs RAPID
19Summary
- 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)
20Summary
- Collected data has multiple uses
- Monitoring individual patient outcomes
- Monitoring practice performance
- Participation in large databases
- Participation in small, independent research