2004 OPEN FORUM Abstracts
UTILIZATION OF A POINT-OF-CARE CASE MANAGEMENT PROGRAM IN A CYSTIC FIBROSIS CENTER.
Reyes JJ, BS RRT-NPS and Hall CR, MS RRT-NPS RPFT. Medical
College of Georgia, Augusta, Georgia.
Background:
Cystic fibrosis patients require that the management of their care be
provided in a timely and efficient manner to reinforcement
therapeutic objectives. This requires collection and review of
significant amounts of data. However, it is frequently difficult and
cumbersome to obtain and record point-of-care information in an
easily retrievable format during patient visits. Handheld
computerized devices such as personal data assistants (PDAs) now
offer an innovative method for obtaining and storing pertinent
clinical information by the clinician. Recent studies have
demonstrated the effectiveness and efficiency of the device as a
clinical tool. Thus, use of this tool by a clinician to store and
retrieve information may be helpful when caring for patients on
routine visits.
Methods: We developed and implemented a
patient database program using commercially available software
(HanDbaseTM) on a PDA (Sony ClieTM) and desktop
computer for our local outpatient Cystic Fibrosis Center to be used
by a Respiratory Care Practitioner (RCP) who is the Cystic Fibrosis
Educator. Patient demographics, limited physical assessment, current
therapeutic modalities, and environmental tobacco exposure were
recorded during the initial visit. The RCP used the PDA to review the
patient history and current treatment modalities. Previous PDA data
was available during all follow-up center visits and updated as
necessary to provide continuum of care. The PDA was routinely synced
to a desktop computer for database backup. Encryption security
measures were incorporated into the database to meet current health
care privacy standards.
Results: We successfully implemented
the case management program in 90 pediatric and 30 adult cystic
fibrosis patients from age zero to 55 years old over an 18 month
period. We found the use of the PDA afforded the RCP opportunity to
easily obtain and document pertinent clinical information in a timely
manner while moving through various clinical settings in the Cystic
Fibrosis Center. Use of the PDA facilitated effective follow-up of
previous patient education information and the patient’s proper
use of therapeutic interventions since the previous visit. Less time
was used for information gathering and review of the patient’s
history; thus, allowing more time for patient education. No problems
were noted in managing the data base information.
Conclusion:
A point-of-care database program using a portable PDA was
successfully incorporated into our Cystic Fibrosis Center. Our
experience demonstrates that a PDA is useful for performing
point-of-care data acquisition and facilitates patient management
over time. Thus, utilization of these devices to deliver a case
management program in other areas may result in efficient data
acquisition at the point-of care and enhance the continuum of care.