Rural Health Network Uses EHRs to Improve Diabetes Care

Posted by admin on June 29, 2008 under News | Be the First to Comment

NC/SC JUN 2008

By Anna Marquez Cook
CCME Creative Services Coordinator
Nine primary care practices from South Carolina’s Lakelands Rural Health Network recently completed a special CCME-led collaborative to effectively use patient data to improve quality care. Two groups of primary care providers from Lakelands Rural Health Network in Greenwood, SC, have taken part in a unique, nine-month collaborative that examined medical records to improve cardiovascular health for diabetes patients. What set this project apart from similar initiatives was the fact that all nine practices independently collected, managed, and reported clinical measures data for analysis using their respective electronic health records (EHRs). The project, entitled the South Carolina Bridging the Gap in Chronic Care Collaborative, focused on diabetes care measures for patients who had cardiovascular disease with a comorbidity of diabetes. It was sponsored by The Carolinas Center for Medical Excellence (CCME) and the South Carolina Department of Health and Environmental Control, Division of Heart Disease and Stroke Prevention. The Lakelands Network is a nonprofit, multi-county, health network developed in 2004 to achieve efficiencies, expand access, and improve the quality of essential care services, while strengthening the rural health care system as a whole. “Primary care physicians were asked to participate in this project because they are the backbone of the health care system and can have a great impact on patient health status,” said Jennifer Anderson, MHSA, PMP, electronic health records consultant at CCME. “And in a rural care network, they are sometimes the sole provider of health care to the community. This collaborative was unique because we worked with rural primary care physicians who had already adopted EHRs. With new studies indicating EHR adoption rates of 17 percent, it is extraordinary to have a collaborative in the rural health setting where all of the practices have EHRs and can generate quality measure reports from their systems.” The project began in October 2007 and was completed this month. The practices have been closely guided by CCME during monthly conference calls, on-site visits, and multiple learning sessions. The collaborative sought to improve outcomes for the following clinical measures:

1. Patients with blood pressure < 130/80.
2. Patients with low density lipoprotein cholesterol < 100mg/dL.
3. Patients with glycosylated hemoglobin (HbA1c) < 7.0 percent.
4. Patients who had a foot exam in past year.
5. Patients who had a diabetes eye exam in the past year.
6. Patients who had a nephropathy assessment in the past year.

The American Diabetes Association reports that one out of every five health care dollars is spent caring for someone with diagnosed diabetes. Diabetes-related hospitalizations totaled 24.3 million days in 2007, an increase of 7.4 million days from 2002. The average cost for a hospital inpatient day due to diabetes is $1,853. The average cost is even higher, at $2,281 per inpatient day, for diabetes-related complications, including neurological, peripheral, vascular, cardiovascular, renal, metabolic, and ophthalmic complications.
“Our goal for the collaborative was to improve the systems within the primary care office to make sure diabetic patients are getting the care they need so the patient and the provider can prevent an unnecessary hospital stay,” Anderson said. “The practices participating in the collaborative were deeply committed to making the changes necessary to improve the health status of their patients.” Because of the short duration of the project, Anderson said it will be difficult to determine if each practice’s measures improved significantly. She is hoping CCME will be able to resume the collaborative this fall.
“The impact of the collaborative is far-reaching,” she said. “The patients of the practices have a greater likelihood of getting the services that they need for their diabetic care. They are more likely to have foot exams, eye exams, and A1c tests because the practices have closely monitored their data during these last few months. The practices participating in the collaborative have learned how to improve the quality of care they provide and, because they have an EHR, they will be able to measure their improvement.”
For more information, contact Jennifer Anderson, MHSA, PMP, at 800-682-2650, ext. 2004.