Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Development of a Tool by Adapted Delphi Procedure.
arterial hypertension
asthma
chronic heart failure
diabetes mellitus type 2
electronic medical record
indicators
monitoring of chronic diseases
osteoarthritis
primary care
Journal
JMIR medical informatics
ISSN: 2291-9694
Titre abrégé: JMIR Med Inform
Pays: Canada
ID NLM: 101645109
Informations de publication
Date de publication:
25 Mar 2020
25 Mar 2020
Historique:
received:
24
04
2019
accepted:
21
01
2020
revised:
18
09
2019
entrez:
27
3
2020
pubmed:
27
3
2020
medline:
27
3
2020
Statut:
epublish
Résumé
Long-term care for patients with chronic diseases poses a huge challenge in primary care. There are deficits in care, especially regarding monitoring and creating structured follow-ups. Appropriate electronic medical records (EMR) could support this, but so far, no generic evidence-based template exists. The aim of this study is to develop an evidence-based standardized, generic template that improves the monitoring of patients with chronic conditions in primary care by means of an EMR. We used an adapted Delphi procedure to evaluate a structured set of evidence-based monitoring indicators for 5 highly prevalent chronic diseases (ie, diabetes mellitus type 2, asthma, arterial hypertension, chronic heart failure, and osteoarthritis). We assessed the indicators' utility in practice and summarized them into a user-friendly layout. This multistep procedure resulted in a monitoring tool consisting of condensed sets of indicators, which were divided into sublayers to maximize ergonomics. A cockpit serves as an overview of fixed goals and a set of procedures to facilitate disease management. An additional tab contains information on nondisease-specific indicators such as allergies and vital signs. Our generic template systematically integrates the existing scientific evidence for the standardized long-term monitoring of chronic conditions. It contains a user-friendly and clinically sensible layout. This template can improve the care for patients with chronic diseases when using EMRs in primary care.
Sections du résumé
BACKGROUND
BACKGROUND
Long-term care for patients with chronic diseases poses a huge challenge in primary care. There are deficits in care, especially regarding monitoring and creating structured follow-ups. Appropriate electronic medical records (EMR) could support this, but so far, no generic evidence-based template exists.
OBJECTIVE
OBJECTIVE
The aim of this study is to develop an evidence-based standardized, generic template that improves the monitoring of patients with chronic conditions in primary care by means of an EMR.
METHODS
METHODS
We used an adapted Delphi procedure to evaluate a structured set of evidence-based monitoring indicators for 5 highly prevalent chronic diseases (ie, diabetes mellitus type 2, asthma, arterial hypertension, chronic heart failure, and osteoarthritis). We assessed the indicators' utility in practice and summarized them into a user-friendly layout.
RESULTS
RESULTS
This multistep procedure resulted in a monitoring tool consisting of condensed sets of indicators, which were divided into sublayers to maximize ergonomics. A cockpit serves as an overview of fixed goals and a set of procedures to facilitate disease management. An additional tab contains information on nondisease-specific indicators such as allergies and vital signs.
CONCLUSIONS
CONCLUSIONS
Our generic template systematically integrates the existing scientific evidence for the standardized long-term monitoring of chronic conditions. It contains a user-friendly and clinically sensible layout. This template can improve the care for patients with chronic diseases when using EMRs in primary care.
Identifiants
pubmed: 32209535
pii: v8i3e14483
doi: 10.2196/14483
pmc: PMC7142740
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e14483Informations de copyright
©Leandra Christina Falck, Marco Zoller, Thomas Rosemann, Nahara Anani Martínez-González, Corinne Chmiel. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 25.03.2020.
Références
Ann Intern Med. 2012 Oct 2;157(7):482-9
pubmed: 23027319
Saudi Pharm J. 2014 Dec;22(6):522-7
pubmed: 25561864
Healthc (Amst). 2014 Mar;2(1):33-9
pubmed: 26250087
Int J Med Inform. 2002 Apr;65(1):7-16
pubmed: 11904244
Cardiovasc Diabetol. 2015 Aug 07;14:100
pubmed: 26249018
JMIR Med Inform. 2019 May 24;7(2):e10879
pubmed: 31127717
N Engl J Med. 2011 Sep 1;365(9):825-33
pubmed: 21879900
Inform Prim Care. 2003;11(2):61-8
pubmed: 14567872
BMC Med Inform Decis Mak. 2015 Aug 22;15:70
pubmed: 26296994
BMC Health Serv Res. 2011 Aug 18;11:199
pubmed: 21851620
J Rheumatol. 2014 Jun;41(6):1155-62
pubmed: 24737907
Int J Med Inform. 2015 Nov;84(11):920-32
pubmed: 26296433
Am J Public Health. 1984 Sep;74(9):979-83
pubmed: 6380323