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 . Martin J Bergman, MD Chief—Rheumatology Taylor Hospital Ridley Park, PA. Patient Encounters. The average Rheumatologist sees: 19 encounters/day-- 4 days/wk 3574 patient visits/year.

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Data collection in private practice and implementation with electronic medical records l.jpg

Data Collection in Private Practice and Implementation with Electronic Medical Records

Martin J Bergman, MD

Chief—Rheumatology

Taylor Hospital

Ridley Park, PA


Patient encounters l.jpg
Patient Encounters Electronic Medical Records

  • 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


Of office based physicians using emr l.jpg
% of Office-based Physicians using EMR Electronic Medical Records

CDC-National Center for Health Statistics--2006


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% of Office-based Physicians using EMR Electronic Medical Records

CDC-National Center for Health Statistics--2006


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Use of Billing Software vs EMR Electronic Medical Records

CDC-National Center for Health Statistics--2006


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Obstacles to EMR Electronic Medical Records

  • Cost

    • Ranges from $5000 to >$30000

  • Loss of Productivity

    • “Steep learning curve”

  • Integration into Group Setting

    • Networking

    • Competing practice styles

  • Technophobia


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Advantages of EMR Electronic Medical Records

  • 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


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Data Collected Electronic Medical Records

  • Demographics

    • Age

    • Sex

    • Employment status

  • Diagnoses

    • Active and Co-morbid

  • Medications

    • Active and Past


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Data Collected Electronic Medical Records

  • Labs

  • Patient reported measures

    • Pain

    • Patient Global

    • Function (MDHAQ)

    • RAPID

    • Fatigue

    • MD Global

    • Tender and Swollen Joint Counts

    • DAS28



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Patient completes questionnaire while waiting for visit questionnaires

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


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Methods of Entering Data questionnaires

  • Paper questionnaire

    • Manually entered or scanned

  • Desktop

    • Increase in physical space required

  • PDA

    • Small screen and small size is advantage and disadvantage

  • Laptop

    • Cost


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Entering data into a computer does not decrease productivity questionnaires

Computer

Paper

Paper

T Pincus, M Bergman, Y Yazici, J Roth, C Swearingen Abstract 1764

ACR 2006 Washington DC


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Uses of Data questionnaires

  • “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


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Graphing of Patient Response questionnaires

MTX

ADA


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Practice Statistics questionnaires



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DAS28 vs RAPID questionnaires


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Summary questionnaires

  • 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)


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Summary questionnaires

  • Collected data has multiple uses

    • Monitoring individual patient outcomes

    • Monitoring practice performance

    • Participation in large databases

    • Participation in small, independent research