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Osteoporos Int. 2009 Jan;20(1):37-42. doi: 10.1007/s00198-008-0635-x. Epub 2008 May 21.

Improving detection and treatment of osteoporosis: redesigning care using the electronic medical record and shared medical appointments.

Author information

  • 1Geisinger Health System, State College and Danville, 200 Scenery Drive, State College, PA, 16803, USA. wayoub@geisinger.edu

Abstract

To determine whether a process redesign could improve detection and treatment of osteoporosis, at-risk women over the age of 65 were identified using an electronic medical record and proactively contacted by letter and phone call. This resulted in a significant increase in testing for osteoporosis by DXA scan. The high-risk patients were then offered a shared medical appointment, which resulted in improved treatment outcomes compared to usual care.

INTRODUCTION:

Our objective was to determine if redesigning care through proactive contact with women 65 at-risk of osteoporosis increased BMD testing and to determine if a shared medical appointment (SMA) improved treatment for high-risk women.

METHODS:

Two primary care sites received the redesign intervention and two other sites served as the usual care controls. At the intervention sites, all women 65 who had not had a DXA scan performed in the prior 2 years were contacted by mail and phone calls. High-risk patients were invited to attend a SMA or follow-up visit with their primary physician.

RESULTS:

A significantly higher proportion of women at the intervention sites had a DXA (39.6% vs. 13.2%, p < 0.0001). Patients who attended the SMA were more likely to have calcium and vitamin D recommended, a vitamin D level checked, and receive a prescription medicine than those patients who had follow-up with their primary care physician.

CONCLUSIONS:

The redesigned process was highly effective in improving BMD testing for women 65. The SMA was shown to be a more effective method to make calcium and vitamin D recommendations, to evaluate secondary causes of low bone density, and to prescribe prescription medications, compared to usual care with the PCP.

PMID:
18493699
DOI:
10.1007/s00198-008-0635-x
[PubMed - indexed for MEDLINE]
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