Evaluation of a CDSS and EMR-Based Registry to Improve Management of Hypertension in a Community Health Center

Slide Presentation from the AHRQ 2008 Annual Conference

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On September 8, 2008, Helene Kopal, MPA, MPH, made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (420 KB).

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Slide 1

Evaluation of a Clinical Decision Support Systems (CDSS) and Electronic Medical Record (EMR)-Based Registry to Improve Management of Hypertension in a Community Health Center

Helene Kopal, MPA, MPH
Director, Primary Care Development Corporation

Slide 2

Our Team

The colored map shows Westchester County, NY with 4 locations highlighted:

• Primary Care Development Corporation
• Open Door Family Medical Centers
• New York University
• Columbia University: Mailman School of Public Health

Slide 3

Project Design and Timeline

Sep. '07-Dec. '08

• Baseline & Development: Institutional review board (IRB) & Federal Wide Assurance (FWA):
  • Set Objectives
  • Develop Intervention
  • Collect Baseline Data
  • EMR
  • Provider Process
  • Assessment of Chronic Illness Care (ACIC)
  • System Inventory

Nov.-Dec. '08-Mar. '09

• Acceptance:
  • Train Users
  • Implement Intervention
  • Acceptance Period

Mar. '09-Jun. '10

• Intervention:
  • Collect Post-Intervention Data
  • EMR
  • Provider Process

Jun. '10-Sep. '10

• Post-Intervention:
  • Analysis
  • Write-up
  • Dissemination plan

Slide 4

Our Patients

• 72% Hispanic
• 66% Female
• 90% at or below 150% of poverty level

Preliminary Baselines

• 94% screened for hypertension
• 16% reported with hypertension

Slide 5

Our Patients

The pie chart shows blood pressure (BP) control among hypertensives.

• Always: 21%
• Sometimes 50%
• Never: 29%

Slide 6

Our Providers

The bar graph measures the positive attitudes towards guidelines.

• Positive Attitudes Towards Guidelines (N=15):
  • Hypertension (HTN) Care & JNC7: 3.7
  • Clin Prac Guidelines: 3.9

Slide 7

Our Providers

The bar graph measures the satisfaction with eClinicalWorks EMR.

• Satisfaction with eClinicalWorks (ECW) EMR (N=15):
  • Satisfied with ECW: 3.8
  • ECW Made Clin Tasks Easier: 5.4

Slide 8

Developing the Intervention

1. Identify Clinical Objective
2. Identify Objective Class
3. Identify Type & Workflow Step of CDSS
4. Select CDSS Intv'ns
   4½ Create Use-Cases
5. Specify & Validate Each Intv'n

• Note: Osheroff, Jerome A., MD, FACP, FACMI et al. Improving Outcomes with Clinical Decision Support: An Implementer's Guide, Chicago: Healthcare and Information Management Systems Society, 2005.

Current as of December 2008

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Internet Citation:

Evaluation of a CDSS and EMR-Based Registry to Improve Management of Hypertension in a Community Health Center. Slide Presentation from the AHRQ 2008 Annual Conference (Text Version). January 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualmtg08/090808slides/Kopal.htm

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