Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study shows electronic medical records and outreach improve osteoporosis care

24.10.2007
Kaiser Permanente database sets model for secondary osteoporosis prevention: Outreach helps manage disease that kills more older women than breast and ovarian cancer combined

Electronic medical records and outreach programs of e-mail messages, letters and phone calls to patients and their primary care providers after a bone fracture can dramatically improve the diagnosis and management of the patients’ osteoporosis, according to a Kaiser Permanente study in the September issue of the Journal of the American Geriatrics Society. This is the largest study to show that electronic medical records improve the continuity of care for osteoporosis.

“Often when a patient sustains a fracture, there is a disconnect between the treating orthopedist and the patient’s primary care physician. With Kaiser Permanente’s computerized database and integrated care delivery system, we can closely monitor and follow patients with fractures and prevent that disconnect,” said Adrianne Feldstein, MD, MS, an investigator at the Kaiser Permanente Center for Health Research (CHR) in Portland and the lead author of the study. “This intervention has broad applicability to a large group of health care providers – from local health departments to HMOs to PPOs – with access to electronic billing or clinical data. Armed with that data, these health organizations can make sure their patients with fractures get appropriate bone density screening follow up.”

This study of 3,588 women shows that an outreach program targeted to patients with a previous fracture meant there was an improvement from 13.4 percent to 44 percent of patients being evaluated and/or treated for osteoporosis. Osteoporosis management is the receipt of a bone mineral density (BMD) measurement or osteoporosis medication in the six months after a fracture. If widely implemented, this approach could substantially improve the secondary prevention of osteoporosis, according to the study authors.

Osteoporosis, a bone disease that leads to increased risk of fracture, is a prevalent condition in older adults, and affects about 20 percent of women 65 and older. Medication can reduce fracture risk in people with osteoporosis significantly, yet many patients, even those who already sustained a previous fracture, do not receive the necessary BMD screening and subsequent treatment. It is estimated that in 2005 there were 2 million fractures at a cost of $17 billion in the United States; by 2025, this number is expected to increase by 50 percent as the population ages.

“Osteoporosis now causes more deaths annually than breast cancer and ovarian cancer combined," said Dr. Feldstein “This study shows that we can cost-effectively improve management with interventions as simple as e-mails, letters and phone calls. That in turn should reduce fractures and mortality, and improve quality of life.”

Researchers at the Kaiser Permanente Center for Health Research used the organization’s integrated databases to analyze medical records of 3,588 women aged 67 and older who sustained qualifying clinical fractures. The women were members of the health plan in Oregon and had not received a BMD measurement or osteoporosis treatment in the 12 months before the fracture.

The goal of the study was to evaluate the effect of the interventions on the National Center for Quality Improvement, Health Employer Data and Information Set (HEDIS) measure that evaluates the proportion of women age 67 and older who sustained a qualifying clinical fracture and had not received a BMD measurement or osteoporosis treatment in the 12 months before the fracture and who received either of these six months after the fracture.

The study was conducted in two phases: In Phase 1, primary care physicians with eligible patients were sent an electronic medical record (EMR) in-basket message that contained patient-specific clinical guideline advice consistent with national guidelines, as well as offered outreach to the patient. If the PCP elected, patients were then contacted via an introductory letter and phone call by outreach staff, who completed a patient record review, counseled the patients regarding risk of osteoporosis and future fractures, and ordered laboratory testing, medication, or a BMD measurement. During Phase 2 clinicians and staff were eligible for a financial incentive for quality improvement based on the osteoporosis HEDIS measure.

“Although the financial incentive helped staff define what the organizational priority was, being a team player is what drove behavior,” said Dr. Feldstein. “The increase in performance resulted from re-engineering the patient’s care and ensuring continuity of care from orthopedist and primary care physician.”

Danielle Cass | EurekAlert!
Further information:
http://xnet.kp.org/newscenter
http://www.kp.org

More articles from Studies and Analyses:

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

nachricht Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>