What is an asthma registry?
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A list of patients with asthma
A source of data for asthma management
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individual patient level
individual provider level
clinic level
community (multi-clinic) level
A tool to incorporate guidelines into practice
How is a registry different than an electronic medical
record?
How can registries be used?
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Database (flowsheet) for clinical encounters
Tracking care of individual patients
Feedback to providers
Recalling patients for follow-up
Identifying patients who need added support
Measuring clinic performance
Meeting data requests from funders
Measuring community-level asthma control
Types of registries
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Paper-based
Computer-based
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DEMS
CDEMS
PECS
Improving Chronic Illness Care
Dozens more!
What is in an asthma registry
What is in an asthma registry
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Demographics
Co-existing conditions
Environmental
exposures
Medications
Asthma control tools
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Self management
actions
Education provided
Services provided
Referrals
Outcomes
Registry content
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Review elements in CDEMS
Question: how to determine severity?
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computed
provider determined
combination
Hints for using registry
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mini-manual
severity classification chart
steroid dosing chart
self-management goal list (next slide)
others?
Self-management goals
Environmental
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Reduce tobacco exposure
Quit smoking
Eliminate roaches
Remove pets from home
Wash sheets in hot water
Put on bedding covers
Reduce moisture in home
Eliminate mold
Medical
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Use preventive medicine
every day
Monitor for asthma
symptoms
Use inhalers effectively
Use action plan and peak
flow meter
Provide action plan to school
or childcare
Registry content
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Add medication list including dosing?
Other?
Moving data: how do want to do it?
Find last registry
note in chart
Place note in
chart
Enter data and
print new note
Review and
update note
Transfer note to
data entry staff
Reports: what do you want?
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Level of report
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All patients
Subsets of patients: which?
By provider
Within clinic
Across clinics (entire collaborative)
Confidentiality
Reports: what do you want?
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Asthma summary report (see handout)
List of patients with visit in time period X
List of patients on X med
List of patients with X health condition
List of patients receiving/not receiving X service
List of patients with X outcome
List of patients with X outcome and with/without Y
service
Reports: what do you want?
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Recall reports: Lists of patients with:
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mild intermittent stable asthma to be seen in 4-6 months
persistent stable asthma to be seen in 3-4 months
newly prescribed controller to be seen in 1 month
acute exacerbation to be seen next day
Other registry issues?
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Dealing with multiple chronic conditions
Other?