Using a Registry to Manage Asthma Population James Wiley, MD Physician Leader, Alabama AAP Chapter...

Using a Registry to Manage Asthma Population

James Wiley, MDPhysician Leader, Alabama AAP Chapter

Stephen Pleatman, MDPediatrician, Suburban Pediatric Associates, Inc.

Board Member, Ohio Valley Primary Care Associates, L.L.C.Cincinnati, Ohio

AAP Chapter Quality Network Asthma InitiativeAlabama Chapter-Learning Session 1

September 17, 2009

What is a registry?

A registry is a list of patients and their relevant clinical data that can be sorted by a condition or set of conditions in order to improve and monitor the care of the population

Adapted from Improving Chronic Illness Care; www.improvingchroniccare.org

Importance of Registry to CQN Asthma Initiative

(insert key messages/bullet points from national AAP and Alabama chapter leadership)

(Alabama/AAP leadership may want to use the following “fear vs. fact” slides to reinforce value/importance of registries to improvement)

Registries: Facts vs. Fears

Fear: “Why is a registry vital to quality improvement efforts?”

Fact: Planned, population-based care cannot be done without knowing your patient population and related key clinical data.

Fact: Primary care teams that implement registries are more likely to improve processes of care and outcomes for populations with chronic conditions.

Fact: Teams with registries are less likely to lose patients to follow-up, and more likely to improve patient satisfaction as care improves.

Adapted from Improving Chronic Illness Care; www.improvingchroniccare.org

Registries: Facts vs. Fears

Fear: “I don’t need anyone telling me how to practice! I’m doing just fine with my patients!”

Fact:Surveys show that providers consistently under- estimate the number of patients with chronic disease in their practice.

Fact:Surveys show that providers consistently over- estimate their performance on quality measures for chronically ill patients.

Fact: Knowing your population of patients will help address this disparity.

Adapted from Improving Chronic Illness Care; www.improvingchroniccare.org

Registries: Facts vs. Fears

Fear: “It’s just more work during our already hectic day!”Fact: Using a patient summary form from a registry will

actually reduce charting time and make the visit run more smoothly.

Fact: The form gives a snapshot of past care, reminders of needed care and planning for future care, all at the time of the visit.

Fact: Teams with registries feel better prepared for visits since they have the patient information when they need it.

Adapted from Improving Chronic Illness Care; www.improvingchroniccare.org

Registries: Facts vs. Fears

Fear: “This will cost me a fortune and there’s no return on investment!”

Fact: Implementing a registry is simple, and there are economies of scale as you add more patients.

Fact: Registries facilitate population-based care, which improves outcomes and patient satisfaction.

Fact: Planned care via the registry generates visits that are typically of higher intensity, while reducing unexpected visits for acute exacerbations.

Adapted from Improving Chronic Illness Care; www.improvingchroniccare.org

Ideal Features of a Registry

• Guides clinical care first, measurement second!

• Quick to implement

• Simple to use

• Data entry simple and efficient

• Incorporates other automated data sources

• Stratifies patients by complexity/severity

Adapted from Improving Chronic Illness Care; www.improvingchroniccare.org

Registry Strategy

(insert key messages/bullet points from national AAP and Alabama chapter leadership)

Cincinnati Case Study:Using PHO Asthma Registry/Data to Drive Improvement

Stephen Pleatman, MDPediatrician, Suburban Pediatric Associates, Inc.

Board Member, Ohio Valley Primary Care AssociatesCincinnati, Ohio

Log In Screen

Dashboard

Process Dashboard (Year End 2008 Results) Outcomes Dashboard (Year End 2008 Results)

State of Asthma Care

Key Outcome Statistics

View existing patient’s demographics, encounter dates, and flu history

Asthma Encounters Demographics Section

Visit Planner

High Risk Patient List

Utilization Report

Improving Influenza Immunization Rates

Work List Patients who have not had a Flu Shot

Improving Influenza Immunization Rates

Improving Influenza Immunization Rates

Flu Shot %

2008/2009 Flu Season

HL

Web-based Asthma Reconfirmation

Reconfirmation Progress by Practice

Type here2009 Reconfirmation Progress by Practice

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Practice (n=# Patients to Review)

% Added % Excluded % RemainingLast Updated 9/1/2009

Asthma Reconfirmation Work List