Improving the Quality of Care of Patients With Rheumatic Disease Using Patient-Centric Electronic Redesign Software
Improving the Quality of Care of Patients With Rheumatic Disease Using Patient-Centric Electronic Redesign Software
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DOI：
10.1002/acr.22479
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发表时间：
2015-04-01
影响因子：
4.7
通讯作者：
Kirchner, H. Lester
中科院分区：
文献类型：
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作者：
Newman, Eric D.;Lerch, Virginia;Kirchner, H. Lester
电子健康记录（EHR）并不适合慢性病管理。为了提高风湿性疾病患者的护理质量，我们开发了电子数据采集，汇总，显示，和documentation software.MethodsThe软件集成和重新组装的信息从病人（通过触摸屏问卷），护士，医生，和EHR到一系列的可操作的意见。核心功能包括随时间推移的趋势、流变学相关人口统计学以及患者和提供者的文档。收集的质量指标包括患者报告的结局、疾病活动和功能。该软件在3个风湿病科进行了测试和实施，并集成到日常护理服务中。实施后评估测量采用，效率，生产力，和patient perception.ResultsOver 2 years，6，725例患者完成了19，786触摸屏问卷。该软件被86%的患者和风湿病学家采用。图表审查和文档编制时间呈下降趋势，生产力提高了26%。患者满意度、激活和依从性保持不变，尽管实施前的数值很高。一个很强的相关性被认为是使用软件和疾病控制（加权皮尔逊相关系数0.5927，P = 0.0095）之间，和一个相对增加的患者低疾病活动的3%per quarter were noted.ConclusionWe描述创新的软件，聚合，存储和显示信息至关重要，以提高慢性风湿性疾病患者的护理质量。该软件被患者和供应商广泛采用。实施后，护理质量，护理效率和生产力的显着改善被证明。
ObjectiveElectronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software.MethodsThe software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatology-related demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception.ResultsOver 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P = 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted.ConclusionWe describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated.