Technology-Enabled Outreach to Patients Taking High-Risk Medications Reduces a Quality Gap in Completion of Clinical Laboratory Testing
| Autor: | Emily B. Schroeder, Rex Astles, Joseph A. Chorny, Ira M. Lubin, David J. Silverman, Susan M. Shetterly, Bharati Bhardwaja, Andrew T. Sterrett, Tyson P. Hagen, Marsha A. Raebel |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality management Leadership and Management media_common.quotation_subject Reminder Systems Population Article Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Interactive voice response Health care Medicine Electronic Health Records Humans Medical physics Quality (business) 030212 general & internal medicine education media_common Aged Aged 80 and over education.field_of_study Text Messaging business.industry Clinical Laboratory Techniques 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Middle Aged Quality Improvement Data warehouse Test (assessment) Outreach Health Communication Antirheumatic Agents Female Drug Monitoring 0305 other medical science business |
| Zdroj: | Popul Health Manag |
| Popis: | Clinical laboratory quality improvement (QI) efforts can include population test utilization. The authors used a health care organization’s Medical Data Warehouse (MDW) to characterize a gap in guideline-concordant laboratory testing recommended for safe use of antirheumatic agents, then tested the effectiveness of laboratory-led, technology-enabled outreach to patients at reducing this gap. Data linkages available through the Kaiser Permanente Colorado MDW and electronic health record were used to identify ambulatory adults taking antirheumatic agents who were due/overdue for alanine aminotransferase (ALT), aspartate aminotransferase (AST), complete blood count (CBC), or serum creatinine (SCr) testing. Outreach was implemented using an interactive voice response system to send patients text or phone call reminders. Interrupted time series analysis was used to estimate reminder effectiveness. Rates of guideline-concordant testing and testing timeliness in baseline vs. intervention periods were determined using generalized linear models for repeated measures. Results revealed a decrease in percentage of 3763 patients taking antirheumatic agents due/overdue for testing at any given time: baseline 24.3% vs. intervention 17.5% (P < 0.001). Among 3205 patients taking conventional antirheumatic agents, concordance for all ALT testing was baseline 52.8% vs. intervention 65.4% (P < 0.001) among patients chronically using these agents and baseline 20.6% vs. intervention 26.1% (P < 0.001) among patients newly starting these agents. The 95(th) percentiles for days to ALT testing were baseline 149 vs. intervention 117 among chronic users and baseline 134 vs. intervention 92 among new starts. AST, CBC, and SCr findings were similar. Technology-enabled outreach reminding patients to obtain laboratory testing improves health care system outcomes. |
| Databáze: | OpenAIRE |
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