1. Using Antibiotics Wisely
Our call will begin at 12:15pm

2. Using Antibiotics Wisely
Team Lead Call #7
Diane Liu, MD
Assistant Professor, Pediatrics
Co-Director, UPIQ

3. Agenda Follow-up discussion regarding Sexually Transmitted Diseases
Update on data for all measures
ICD-10
Next Learning Session/Team Lead call
6 month follow-up with UPIQ
ADHD Project

4. Questions
What do other physicians do when they perform a strep test sort of knowing that they are only doing it to satisfy the parent, but it comes back positive because the child is a possible carrier….Then the throat culture comes back negative, but the parent still wants antibiotics for the “positive” strep?
How do we test for Mycoplasma genitalium?

5. Questions, continued
Dr. Keeshin has provided the lab orders she uses for STI’s:
Mycoplasma genitalium:
Ureaplasma and Mycoplasma Species by PCR (Code: Lab4230 -in the University of Utah EPIC EMR)
If at a IHC site: Urogenital Ureaplasma and Mycoplasma Species by PCR (ARUP )
Chlamydia/Gonorrhea:
Chlamydia T & Gonorrhoeae by TMA (LAB2035)
IHC: can be written the same
HIV
HIV: HIV-1,2 COMBO AG/AB EIA W/reflx (LAB3861) or HIV COMBO Ag/AB RFLX HIV-1AB Conf. BY WB (LAB2912)
IHC: Human Immunodeficiency Virus (HIV) 1/2 Combo Antigen/Antibody (HIVC)  

6. 9/9
8/8
782/793
70/793
97/110
53/65
70/104
21/32
1/2
6/65
7/108
41/782
0/2

7. (0/5)

8. Rational Documentation Baseline
If antibiotic prescribed, was there a rationale documented?
Cough 782.6
465.9 Acute, URI
None documented
Respiratory Infection 519.8
ears look questionable and family is traveling SNAP
Going out of town and with sorethroat symptoms and otalgia with red ear antibiotic given as snap rx.
16-year-old female with likely acute bronchitis that is viral in nature. She is in no red flags on exam. Supportive management has been discussed. However symptoms persist or worsen she may fill the antibiotic prescription for possible pertussis versus w
Your child's rapid strep test was negative. He has been exposed to Strep throat and may still be at risk for developing this infection. If he has fever, worsening sore throat or pain with eating, this may be signs of strep throat. If your child develops t
1. Asthma exacerbation (Primary) 2. Cough Upper respiratory infection
Otalgia of left ear
Dizziness
Upper respiratory infection
Upper respiratory infection 465.9
Fever
Asthma Exacerbation
URI 465.9
URI, acute (Primary)
522.4 DENTAL INFECTION
SNAP Med
No reason identified
SNAP prescription. child had some ear ache
Written as a SNAP
Child had a diagnosis of 490- Bronchitis antibiotic given for that
May
If antibiotic prescribed, was there a rationale documented?
None documented
Discussed with parent and patient that symptoms are likely viral in nature however symptoms do progress, she may fill a safety net antibiotic prescription in 5 days. ER and follow up precautions have also been reviewed.
July
If antibiotic prescribed, was there a rationale documented?
None documented

9. N=652/680
N=34/34
N=529/652
N=87/112

11. Primary ICD 9 Dx that would rationalize using an Abx vs those which no Abx would be appropriate

12. University Pediatric Clinic & South Main Clinic

13. Utah Valley Pediatric North & Timpanogos

14. July Data-Due August 15th Children with pharyngitis
Practice
Children with pharyngitis
Children with URI
Blanding
Submitted
Comfort Care
Granger Fam Med
Missing
Granger Peds
Granger Urgent Care
South Jordan
South Main
UPC
UVP North
UVP Timpanogos
Village Green

15. August Data-Due September 15th
Practice
AOM
Sinusitis
Blanding
Submitted
N/A
Comfort Care
Granger Fam Med
Missing
Granger Peds
Granger Urgent Care
South Jordan
South Main
UPC
UVP North
UVP Timpanogos
Village Green

16. ICD-9 Data-Due Now Practice ICD-9 Data
Blanding
N/A
Comfort Care
Requested
Granger Fam Med
Granger Peds
Granger Urgent Care
South Jordan
South Main
Submitted
UPC
UVP North
UVP Timpanogos
Village Green

17. ICD-10

18. CDC Posters for your practice

20. Next OLS #8 Topic Ideas -Skin infections -Respiratory issues -Update on MRSA treatment and eradicating colonization
Date Change for OLS and Team Lead Call in October due to Fall Break/UEA
OLS #8 Thursday, October 29th 12:30pm
Team Lead Call #8, Thursday, November 5th 12:15pm

21. 6 month follow-up with UPIQ

22. We Invite Primary Care Practices to Participate in UPIQ’s
“Improving Diagnosis and Management of ADHD” Learning Collaborative
Your practice team will receive support to:
Understand & use new DSM-V criteria for ADHD
Understand & use ADHD treatment options, including new medication and local therapeutic resources
Identify & address co-morbid and complicating conditions
Target quality measures related to diagnosis and follow-up care
This 10-month project will kick-off with a Learning Session day on
November 13th, 2015 at the Karen Gail Miller Conference Center (9750 S. 300 W., Sandy)
We expect to offer CME credit for educational components and credit toward Part 4 Maintenance of Certification (MOC) for the American Boards of Pediatrics and Family Medicine.
For more information, call (801) , or go to upiq.org
Supported by Healthy U, University of Utah Health Plans' Medicaid plan