Advertisement
Pragmatic Innovations in Post-Acute and Long-Term Care Medicine Feasible new, practical products or approaches intended to improve outcomes or processes in post-acute or long-term care| Volume 21, ISSUE 9, P1349-1352, September 2020

Promoting Osteoporosis Best Practices: A New Electronic Medical Record Tool

      Abstract

      Despite the high prevalence and devastating outcomes associated with osteoporotic fractures, they are not well investigated or treated. We developed an electronic Osteoporosis and Falls Assessment Form for integration within electronic medical records (EMR) with the aim to improve osteoporosis-related care in family practice. We examined usage and collected usability feedback from 37 physicians. A medical record review was used to assess tool usage over a 6-month period after which all participants completed a survey to assess their perceptions of the tool. The tool was used at least once by 22 (59%) physicians with 119 patients. Most users reported that it enhanced their practice (64%) and they intended to use it in the future (71%). Time constraints, complexity, and requirements to manually enter sections were identified as barriers to use. Lessons learned will inform improvements, which, given the perceived value of this tool, will likely improve uptake.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Neuman M.D.
        • Silber J.H.
        • Magaziner J.S.
        • et al.
        Survival and functional outcomes after hip fracture among nursing home residents.
        JAMA Intern Med. 2014; 174: 1273-1280
        • Hopkins R.B.
        • Burke N.
        • Von K.C.
        • et al.
        The current economic burden of illness of osteoporosis in Canada.
        Osteoporos Int. 2016; 27: 3023-3032
        • Leslie W.D.
        • Lix L.M.
        • Langsetmo L.
        • et al.
        Construction of a FRAX(R) model for the assessment of fracture probability in Canada and implications for treatment.
        Osteoporos Int. 2011; 22: 817-827
        • Bessette L.
        • Ste-Marie L.G.
        • Jean S.
        • et al.
        The care gap in diagnosis and treatment of women with a fragility fracture.
        Osteoporos Int. 2008; 19: 79-86
        • Papaioannou A.
        • Giangregorio L.
        • Kvern B.
        • et al.
        The osteoporosis care gap in Canada.
        BMC Musculoskelet Disord. 2004; 5: 11
        • Oertel M.J.
        • Graves L.
        • Al-Hihi E.
        • et al.
        Osteoporosis management in older patients who experienced a fracture.
        Clin Interv Aging. 2016; 11: 1111-1116
        • Pritchard J.
        • Karampatos S.
        • Ioannidis G.
        • et al.
        Osteoporosis guideline implementation in family medicine using electronic medical records.
        Can Fam Physician. 2016; 62: e326-e333
        • DeJesus R.S.
        • Angstman K.B.
        • Kesman R.
        • et al.
        Use of a clinical decision support system to increase osteoporosis screening.
        J Eval Clin Pract. 2012; 18: 89-92
        • Papaioannou A.
        • Morin S.
        • Cheung A.M.
        • et al.
        2010 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary.
        CMAJ. 2010; 182: 1864-1873
        • Osteoporosis Canada
        Osteoporosis and falls assessment custom form.
        (Available at:)
        • Ontario College of Family Physicians
        Tools and resources.
        (Available at:)
        • Thabane L.
        • Ma J.
        • Chu R.
        • et al.
        A tutorial on pilot studies: The what, why and how.
        BMC Med Res Methodol. 2010; 10: 1
        • Rotondi N.K.
        • Beaton D.E.
        • Sujic R.
        • et al.
        Identifying and addressing barriers to osteoporosis treatment associated with improved outcomes: An observational cohort study.
        J Rheumatol. 2018; 45: 1594-1601
        • Solomon D.H.
        • Johnston S.S.
        • Boytsov N.N.
        • et al.
        Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011.
        J Bone Miner Res. 2014; 29: 1929-1937
        • Alami S.
        • Hervouet L.
        • Poiraudeau S.
        • et al.
        Barriers to effective postmenopausal osteoporosis treatment: A qualitative study of patients' and practitioners' views.
        PLoS One. 2016; 11: e0158365
        • Conroy K.M.
        • Elliott D.
        • Burrell A.R.
        Testing the implementation of an electronic process-of-care checklist for use during morning medical rounds in a tertiary intensive care unit: A procpective before-after study.
        Ann Intensive Care. 2015; 5: 20
        • Probst T.
        • Lambert M.J.
        • Loew T.H.
        • et al.
        Feedback on patient progress and clinical support tools for therapists: Improved outcome for patients at risk of treatment failure in psychosomatic in-patient therapy under the conditions of routine practice.
        J Psychosom Res. 2013; 75: 255-261
        • Kastner M.
        • Straus S.E.
        Clinical decision support tools for osteoporosis disease management: A systematic review of randomized controlled trials.
        J Gen Intern Med. 2008; 23: 2095-2105
        • Kennedy C.C.
        • Ioannidis G.
        • Thabane L.
        • et al.
        Successful knowledge translation intervention in long-term care: Final results from the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial.
        Trials. 2015; 16: 214
        • Feldstein A.
        • Elmer P.J.
        • Smith D.H.
        • et al.
        Electronic medical record reminder improves osteoporosis management after a fracture: A randomized, controlled trial.
        J Am Geriatr Soc. 2006; 54: 450-457
        • Damiani G.
        • Pinnarelli L.
        • Colosimo S.C.
        • et al.
        The effectiveness of computerized clinical guidelines in the process of care: A systematic review.
        BMC Health Serv Res. 2010; 10: 2
        • Roshanov P.S.
        • You J.J.
        • Dhaliwal J.
        • et al.
        Can computerized clinical decision support systems improve practitioners' diagnostic test ordering behavior? A decision-maker-researcher partnership systematic review.
        Implement Sci. 2011; 6: 88