September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Comparison of glaucoma care and conformance with Preferred Practice Patterns in a resident clinic setting prior to and after the development of electronic medical records.
Author Affiliations & Notes
  • Ramsudha Narala
    Ophthalmology, Kresge Eye Institute, Royal Oak, Michigan, United States
  • Aws Hasan
    Ophthalmology, Kresge Eye Institute, Royal Oak, Michigan, United States
  • Aman Shukairy
    Ophthalmology, Kresge Eye Institute, Royal Oak, Michigan, United States
  • Bret A Hughes
    Ophthalmology, Kresge Eye Institute, Royal Oak, Michigan, United States
  • Mark Juzych
    Ophthalmology, Kresge Eye Institute, Royal Oak, Michigan, United States
  • Footnotes
    Commercial Relationships   Ramsudha Narala, None; Aws Hasan, None; Aman Shukairy, None; Bret Hughes, None; Mark Juzych, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2597. doi:
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      Ramsudha Narala, Aws Hasan, Aman Shukairy, Bret A Hughes, Mark Juzych; Comparison of glaucoma care and conformance with Preferred Practice Patterns in a resident clinic setting prior to and after the development of electronic medical records.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2597.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate whether conformance with Preferred Practice Patterns, set forth by the American Academy of Ophthalmology, has changed with the development of electronic medical records (EMR) in a resident clinic setting.

Methods : Retrospective study of 206 patient charts from 2006 and 213 patient charts from 2011-2013, diagnosed with primary open angle glaucoma (POAG) or glaucoma suspect seen in the Kresge Eye Institute resident clinic. Compliance with Preferred Practice Patterns (PPP) was evaluated. Recording of visual acuity (VA), intraocular pressure (IOP), gonioscopy, central corneal thickness (CCT), target IOP, cup to disc ratio, slit lamp examination (SLE), dilated fundus examination (DFE) as well attaining Humphrey visual field (HVF) and optical coherence tomography (OCT) were assessed. Comparisons between compliance prior to and after the implementation of EMR were made.

Results : Documentation for new patients during the initial evaluation was 100% for SLE, IOP, and VA in both groups. Documentation of C/D ratio was 95% in 2006 vs 93% in 2011-2013 (p=0.345). Recording of CCT was 77% vs 94% (p<0.001),gonioscopy was 69% vs 74% (p=0.234), and target IOP was 12% vs 1% (p<0.001), respectively, when comparing charts from 2006 vs 2011-2013. DFE within 1 year of initial examination was performed in 97% vs 100% (p=0.007) of patients in 2006 and 2011-2013, respectively. HVF testing occurred in 84% vs 95% (p<0.001) of patients at intervals of 1 year or less in 2006 and 2011-2013, respectively. OCT was done in 62% of patients in 2006 and 92% of patients from 2011-2013 (p<0.001).

Conclusions : Good compliance with all measures was noted except for target IOP in both groups. Compliance was significantly improved with gathering of CCT, HVF, OCT, and DFE in 2011-2013, after the implementation of EMR, versus 2006. All components of PPP are integral to patient care and should be emphasized as part of resident education as it has many implications for the quality of glaucoma care.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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