Improving COPD Management Through Use of Patient EMR Information

Using information in a patient’s electronic medical record (EMR) during outpatient visits for patients with chronic obstructive pulmonary disease (COPD) can lead to better outcomes, according to a study in the journal Respiratory Medicine.

Although COPD places a heavy burden on the healthcare system, with estimated costs of $50 billion in 2010 due to patients with COPD going to emergency departments and being hospitalized, barely half of healthcare providers follow established clinical practice guidelines on how to evaluate and manage patients with the condition.

Lead author Jordan Terasaki, MD, UTMB fellow in the department of internal medicine, division of pulmonary critical care and sleep medicine, explained that the reasons for low compliance with clinical guidelines include lack of awareness, trust in guideline development, and the complexity of recommendations.

Researchers at The University of Texas Medical Branch at Galveston (UTMB) implemented a COPD Flowsheet based on a structured approach using information in the EMR and found an improvement in patient assessments and other quality of care measures.

“Because COPD leads to an overall decline in lung function and quality of life, it is important to optimize the outpatient management of these patients,” Dr Terasaki said in a statement. “Timely access to care or an action plan can avoid emergency room visits and/or hospitalizations in these patients.”

A total of 200 patients were screened in the pre-intervention period and 347 in the post-intervention period and 72% and 77%, respectively, met criteria for COPD. In the post-intervention group, the researchers noted significant increase in the use of severity assessment, inhaler technique teaching, influenza vaccination, referrals to a pulmonary rehabilitation program, and use of both short-acting rescue inhalers and long-acting lung medications.

“This intervention was primarily tested in pulmonary clinics with a goal to spread to all primary care practices at a later time within the health care system as the majority patients with COPD are seen in those practices,” said author Gurinder Pal Singh, MBBS, UTMB fellow in the department of internal medicine, division of pulmonary critical care & sleep medicine. “Future studies should examine the impact of standardized assessment and management on outcomes in patients with COPD.”