Using Data for Practice Quality Improvement to Address Blood Sugar Challenges for Complex Care Patient > 자유게시판

Disclosures: Dr. Omesh Syal is the Chair of Divisions of Family Practice - Prince George, and Chair at HDC. Mitigating potential bias: Recommendations are consistent with published guidelines and current practice patterns. Disclaimer: The Health Data Coalition (HDC) is a physician-led data-sharing initiative that encourages reflection and collaboration with colleagues and facilitates quality improvement in patient care through its HDC Discover application. HDC is a not-for-profit organization, funded by the Family Practice Services Committee (FPSC) and powered by the enthusiasm and dedication of a growing network of family physicians from across the province, with the primary focus of empowering physicians and clinics to understand and use their data for practice improvement. Although type 2 diabetes typically occurs in adults, rates among children are rising. According to BC Ministry of Health data, the number of people diagnosed with type 1 or 2 diabetes in Prince George annually is 544. This population group often becomes complex in nature, with associated comorbidities to manage.

I was identifying diabetes in more of my patients and was curious to see if my hunch of the increasing prevalence was reflected in my patient panel. Prior to registering with the Health Data Coalition (HDC) and having access to a tool like HDC Discover, I would call my Practice Support Program (PSP) coach, and set a time to meet, which may result in a Quality Improvement Facilitation Cycle. We would choose a topic and run practice analysis and reports within our Electronic Medical Records (EMR). From here, we would be able to tailor the clinical quality improvement question. It was more time-consuming than using the HDC Discover application. The HDC Discover application, which is currently in use by primary Glyco Care supplement physicians across British Columbia, provides secure access to aggregated clinical measures while maintaining both patient and physician confidentiality. It is a service that was envisioned by innovative physicians, backed by the Divisions of Family Practice, who believe in the collective impact concept.

I am the Board Chair of the Prince George Division of Family Practice and the Chair of the HDC for which I am humbled to carry forward the insightful work by my mentors and peers before me. HDC Discover allows me to easily visualize my data and provides a view outside of my own clinic through aggregates of my peers within my geographic region and province. While reviewing my HDC data, I noticed that the average HbA1c for my patients living with diabetes was higher than what I thought it should be. I also noticed that this was true in the larger community in which I practice. After looking deeper into EMR data for patients with HbA1c over 7%, I observed that the patients who had the most challenges with their blood sugar were also the patients who needed complex Glyco Care reviews with other comorbidities such as coronary artery disease, COPD, and renal failure. Complex patients often require more time and attention to develop a Glyco Care glucose management plan that is revisited and updated as needed.

Normally I take Friday afternoons to catch up on my practice, so I promptly worked within my EMR to identify a patient list and delegated to my staff to use Friday afternoons to call in our patients living with complex diabetes for a longer consultation on their medications, diet, and exercise. Taking the time to review my patients and ensure I had a plan in place, helped me feel in better control of my practice. This process allowed me to find joy in my work again. It validated myself as a physician, providing great primary care. It’s difficult to find time to test a different process to benefit both patient outcomes and practice objectives. Each physician will find what works best for them, but I want to emphasize that the results of the work are worth it. Patients expressed their happiness that I was spending time with them, and over time, many better understood which individual data points I routinely check and empowered their own self-management plans.