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Design, Testing, and Use of a Pre-Visit Questionnaire to Improve CF Care Brooke Moore, M.D., MPH Pediatric Pulmonologist.

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Presentation on theme: "Design, Testing, and Use of a Pre-Visit Questionnaire to Improve CF Care Brooke Moore, M.D., MPH Pediatric Pulmonologist."— Presentation transcript:

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2 Design, Testing, and Use of a Pre-Visit Questionnaire to Improve CF Care Brooke Moore, M.D., MPH Pediatric Pulmonologist

3 Presenter Disclosure Brooke Moore, MD, MPH There are no relationships to disclose related to this presentation

4 Objectives Discuss initial EMR workflow/build
Review original respiratory follow-up forms (pre-visit surveys) Describe CF Health Check/dashboard project Review pre-visit surveys and patient/family response Discuss next steps

5 Our team/center 157 Pediatric patients 26+ CRMS patients
14 Pulmonary providers 11 see patients with CF

6 EMR build eClinicalWorks (eCW) Implemented in 8/2011
CF specific template designed to capture data that is manually entered into the CF registry

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8 Respiratory Follow-up Form
Provided to all patients (regardless of diagnosis at all visits) Not CF specific

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11 CF Health Check Invited to participate in Dartmouth Institute/RWJ Foundation dashboard project Co-Production of care model Patient reported outcomes Pre-visit Questionnaire Integrated into EMR? CF Health Check is an on-line platform designed with people with CF, families, and clinical care teams to improve the way we work together to manage CF care. It includes longitudinal clinical data from the CF Registry; patient-generated health information, concerns and requests; a summary care plan; and the patient's reported health goals and barriers to sustaining daily care.  It is being tested by 5 CF programs with support from Dartmouth.

12 Patient-reported Outcomes
Patient-reported outcome (PRO) Standardized data items used to obtain information from patients about their health status Improve communication between patients and providers Provide information to screen, diagnose, and monitor conditions

13 Patient-reported Outcomes
Patient-reported outcome (PRO) Many standardized survey instruments exist Few combine patient goals, health, well-being, and barriers to accessing care Difficult to incorporate into existing care processes and to document and display in electronic medical records

14 Pre-Visit Questionnaires
CF-specific PRO surveys Designed using items from standardized instruments, existing clinical intake surveys, and interviews with providers, patients/families, and researchers Piloted at 5 centers between July and September 2016 Feasibility, acceptability, and utility was evaluated Feedback prompted revisions and final versions were issued Designed using items from standardized instruments (CFQOL, GITracker, CFRSD-CRISS, PROMIS

15 Pre-Visit Questionnaires
Based on positive response, Children’s Minnesota incorporated the surveys into all clinic visits Replaced general respiratory survey Completed before each visit Used to engage patients/families in discussion, problem solving, and decisions during visits

16 Pre-Visit Questionnaires
Birth – 11 years 44 questions - 7 categories: Quality of life Pulmonary Abdominal/GI Nutrition Other health areas Medications Concerns/requests Age 12 – 18 Additional questions on urinary symptoms

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21 Pre-Visit Questionnaires
As of September 2017 701 surveys completed Transitioning from paper to online version using CF Health Check

22 Feedback Patients: Questions are more applicable to their care
More focused visit Able to share their top concerns Feel what they want to discuss is addressed Providers: Survey guides conversations about therapies and treatments Allows providers to address patient concerns Provides better understanding of the impact of CF on the lives of patients/families

23 Integrated into EMR? Currently accessed through CF Health Check
Separate log-in Not integrated Future goal would be for data to be integrated: CF Health Check  EMR EMR  CF Health Check CF Health Check  CF Registry CF Registry  CF Health Check The data collected in the PRO survey is displayed in CF Health Check for patients, families, and care teams to review and discuss, and it is exported to the CF Foundation Patient Registry for research.

24 Integrated into EMR? Currently accessed through CF Health Check
Separate log-in Not integrated Future goal would be for data to be integrated: CF Health Check  EMR EMR  CF Health Check CF Health Check  CF Registry CF Registry  CF Health Check

25 CF Health Check

26 CF Health Check

27 Conclusions Having a CF specific template saves time
Using a CF specific PRO questionnaire improves CF care Results in a more focused visit Allows patient/family concerns to be addressed EMR integration between systems is needed

28 Questions?

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