What is an asthma registry?

1
What is an asthma registry?

• A list of patients with asthma
• A source of data for asthma management
• individual patient level
• individual provider level
• clinic level
• community (multi-clinic) level
• A tool to incorporate guidelines into practice
• How is a registry different than an electronic
  medical record?

2
How can registries be used?

• Database (flowsheet) for clinical encounters
• Tracking care of individual patients
• Feedback to providers
• Recalling patients for follow-up
• Identifying patients who need added support
• Measuring clinic performance
• Meeting data requests from funders
• Measuring community-level asthma control

3
Types of registries

• Paper-based
• Computer-based
• DEMS
• CDEMS
• PECS
• Improving Chronic Illness Care
• Dozens more!

4
What is in an asthma registry
5
What is in an asthma registry

• Demographics
• Co-existing conditions
• Environmental exposures
• Medications
• Asthma control tools

• Self management actions
• Education provided
• Services provided
• Referrals
• Outcomes

6
Registry content

• Review elements in CDEMS
• Question how to determine severity?
• computed
• provider determined
• combination
• Hints for using registry
• mini-manual
• severity classification chart
• steroid dosing chart
• self-management goal list (next slide)
• others?

7
Self-management goals

• Environmental
• Reduce tobacco exposure
• Quit smoking
• Eliminate roaches
• Remove pets from home
• Wash sheets in hot water
• Put on bedding covers
• Reduce moisture in home
• Eliminate mold

• Medical
• Use preventive medicine every day
• Monitor for asthma symptoms
• Use inhalers effectively
• Use action plan and peak flow meter
• Provide action plan to school or childcare

8
Registry content

• Add medication list including dosing?
• Other?

9
Moving data how do want to do it?
Find last registry note in chart
Place note in chart
Review and update note
Transfer note to data entry staff
Enter data and print new note
10
Reports what do you want?

• Level of report
• All patients
• Subsets of patients which?
• By provider
• Within clinic
• Across clinics (entire collaborative)
• Confidentiality

11
Reports what do you want?

• Asthma summary report (see handout)
• List of patients with visit in time period X
• List of patients on X med
• List of patients with X health condition
• List of patients receiving/not receiving X
  service
• List of patients with X outcome
• List of patients with X outcome and with/without
  Y service

12
Reports what do you want?

• Recall reports Lists of patients with
• mild intermittent stable asthma to be seen in 4-6
  months
• persistent stable asthma to be seen in 3-4 months
• newly prescribed controller to be seen in 1 month
• acute exacerbation to be seen next day

13
Other registry issues?

• Dealing with multiple chronic conditions
• Other?