The Science Journal of the American Association for Respiratory Care

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.

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