Angie Chlpka Uses Health IT to Improve Health Care Quality for Patients with Asthma
Angie Chlpka is Office Manager at Helping Hands Pediatrics, Inc. (Helping Hands), a small practice founded in 2002 by Dr. Paul Chlpka in Sharon, Pennsylvania. Helping Hands sits on the border between Pennsylvania and Ohio and serves patients in Sharon and the surrounding communities, many of whom qualify for Medicaid. As part of attesting for meaningful use, Helping Hands has been integrating assessment tools, which screen for management and medication adherence for chronic conditions, such as asthma, into their electronic health record (EHR) system. As Office Manager, Angie Chlpka leads the practice’s efforts to optimize their EHR system and achieve Meaningful Use.
The Challenge of Integrating Assessment Tools
One of the biggest challenges Helping Hands faced in satisfying the Meaningful Use clinical quality measures (CQMs) was integrating assessment tools into the practice’s EHR system. Before attesting for Meaningful Use, physicians were already assessing patients for conditions like asthma. However, in order to fully meet one of the CQMs for Meaningful Use, a specific asthma control test tool, which screens patients’ asthma management through a series of questions, had to be administered to patients during the visit. As Chlpka explained, “physicians were concerned that documenting information already collected during a visit might be redundant and time-consuming.” The main challenge was then finding a means of seamlessly integrating the assessment tool into the EHR system and the physician’s workflow.
Integrating assessment tools into the EHR system was the first step. By working with their EHR vendor, Helping Hands developed a system for downloading assessment tools into master documents. The documents could be retrieved and saved into the patient's chart within the EHR system. The practice also initiated a clinical decision support prompt in the EHR system to ensure patients with a specific diagnosis were administered the proper assessment tool. The next step was to educate the care team, including medical assistants and nurses about how to administer the tool, where to find it in the EHR system, and where within their workflow it would fit. Finally, Helping Hands created a report from the EHR system allowing the practice to track progress, which provided data metrics on the percentage of patients with asthma, dates of service within the year, whether an asthma control test was administered, and the date of their next scheduled visit, allowing the team to see the impact of the new tools.
Using Assessment Tools to Improve Health Care Ownership
The assessment tools in the EHR allow Helping Hands to track care and improve health care quality by harnessing patient data. For instance, in January 2012, Helping Hands began administering the asthma control test tool. As of March 2014, providers administered the tool to nearly 80% of the practice’s asthma patients. The integration of assessment tools has resulted in:
- Patient Engagement: The asthma control test tool helps patients reflect on their disease and how it impacts their daily life. In particular, the tool enables patients to judge how well they are managing their disease and helps them better understand their disease.
- Proactive Health Care: Providers and nurses can track patient outcomes on certain measures, such as Medication Adherence, and determine if follow up care is necessary, which helps improve health care quality.
- Improved Health Outcomes: Emergency Department visits declined by 30% within six months of administering the asthma assessment tool.
“Through the integration of assessment tools, the children in our practice really get a chance to think about their disease and how it affects their daily life. This sense of ownership in their disease management was well worth the effort,” explained Angie Chlpka. After successfully integrating the asthma control test tool, Helping Hands is now focusing on incorporating additional tools, such as a depression screening tool to continue to improve health care quality and drive toward Stage 2 meaningful use.