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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Paulette Williams LTC, DrPH1, Lanna Forrest, Ph D2, and Michelle Hill, MPH2. (1) Tripler Army Medical Center (MCPO-PA), 1 Jarrett White Rd., Honolulu, HI 96859-5000, (808) 433-2382, paulette.williams@haw.tamc.amedd.army.mil, (2) AdvanceMed Corporation, 11710 Plaza America Drive, Reston, VA 20190
Baseline rates of compliance to clinical practice guidelines (CPG), patient satisfaction, and cost characteristics of Tripler Army Medical Center’s adult diabetes population (n=931) were established and used to guide the design and implementation of automated clinical practice guideline (ACPG) modules. Data from October 1999 to September 2000 were collected from administrative data sources, electronic and paper medical records, and a patient survey. Data were examined unadjusted and adjusted for relevant risk factors using multivariate techniques, as appropriate. Typical patients are over 60, female, and have been diagnosed with diabetes 10+ years. Over 90% rate their diabetes care as Excellent/Good. Only 25% are insulin-dependent, and 20% are hospitalized during the study period. The majority exhibits at least one diabetes-related complication; 84% have clinical hypertension. HbA1c levels are borderline high. CPG adherence is high (75% +) for foot examinations, lipid testing, patient education, and HbA1c testing. Rates are lower for eye examinations (60%) and microalbumin testing (34%). Results from the baseline study phase have impacted structuring of the ACPG implementation process: (1) the system prompts physicians to order screening tests/procedures for patients exhibiting risk factors associated with the identified negative clinical outcomes; (2) there are plans to monitor the impact of the ACPG on patients, given their perception of good health and satisfaction with their providers’ management of their diabetic care; and (3) the impact of the ACPG on provider adherence rates will be examined specifically for eye examinations and microalbumin testing.
Learning Objectives:
Keywords: Performance Measurement, Patient Satisfaction
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.