Web-Based Tool Helps Doctors Improve Care

A Web-based population care tool that extracts information from electronic medical records (EMRs) helps primary care physicians improve care and manage their entire panel of patients.

The Panel Support Tool (PST), developed by researchers at Kaiser Permanente (Oakland, CA, USA) is a web-based tool that compares the care the patient is receiving to the care that is recommended by national guidelines. For example, doctors can query the PST in advance of a patient visit to find out if that patient needs a screening test or vaccine. They can ask the PST to display a list of all of their patients who are overdue for a mammogram or colon cancer-screening test, or a list of their diabetic patients whose blood sugar levels are too high, or those who need a foot or eye exam.

To test the effectiveness of the PST tool, the researchers conducted a retrospective, longitudinal study that followed 204 primary care teams who were using the PST to manage care for 48,344 patients with diabetes and/or heart disease. The study used 2005 as the preintervention, 2006 as the implementation, and 2007 as the postintervention periods. The care recommendations measured included blood sugar levels, blood pressure (BP) screening and control, retinopathy, nephropathy, foot screening, use of aspirin, statins, angiotensin converting enzyme inhibitors and beta blockers, and influenza and pneumococcal vaccination. The researchers found that after three years, the percentage of care recommendations met every month for patients with diabetes increased from 67.9 % to 72.6%; in heart disease patients, the percentage rose from 63.5% to 70.6%. The study was published in the October 2010 issue of the American Journal of Managed Care.

"Patients in the U.S. receive only about half of the preventive and follow-up care now recommended by national guidelines. Our study shows that, by using the innovative Panel Support Tool, in conjunction with the electronic medical record, we can provide patients with more of the care they are supposed to receive,” said lead author Adrianne Feldstein, M.D., M.S.

Most recommendations monitored by the PST tool are derived from the Healthcare Effectiveness Data and Information Set (HEDIS), a tool developed by the U.S. National Committee for Quality Assurance (NCQA, Washington, DC, USA), and used by more than 90% of American health plans to measure performance on important dimensions of care and service. Other recommendations reflect organizational priorities based on peer-reviewed literature, as well as internal research at Kaiser Permanente.

Related Links:
Kaiser Permanente
U.S. National Committee for Quality Assurance