Impact of an EHR-based tool on COPD Management in Primary Care

Background: GOLD (2017) guidelines provide evidence based recommendations for treating COPD, although their employment in clinical practice is inconsistent. Lack of a standardized method to view COPD specific information within the EHR during patient encounters complicates visits and development of GOLD-guided treatment plans. Our goal is to determine the impact of an EHR-based tool on relevant COPD disease measurements (spirometry rates, pneumococcal vaccination rates and COPD Action plans) Methods: An EHR-based tool (SmartPhrase) was developed and released to providers to facilitate GOLD(2017) guideline reference during patient encounters. Computer based instructional videos of GOLD (2017) guidelines and EHR-based tool were presented to providers prior to 90 day intervention. A two-pronged pre-and post-intervention analysis was carried out examining 1) subjective provider application of GOLD (2017) guidelines, and 2) objective inclusion of GOLD guidelines within the EHR patient encounter of COPD patients aged \u3e 18 at a rural Primary Care clinic. Results: Compared to pre-intervention, providers reported EHR-tool was rated as ‘likely’ to improve job performance and effectiveness when treating COPD patients (from 42.8% to 75%) and ‘likely’ to make documenting COPD-specific data easier (28.5% to 75%), increased tendency to order Spirometry (33.9%) and refer to Pulmonary Rehab more frequently (25%). Compared to pre-intervention, objective changes in spirometry rates increased 3.9%, vaccination rates for PCV13 and PPSV23 increased slightly (both 1.9%); there were no changes in number of COPD Action plans. Conclusions: Preliminary data suggests that an EHR-based tool is a potentially effective tool to increase awareness and application of GOLD guidelines in the treatment of COPD in Primary Care. Increased intervention period of 12 months may provide more insight into changes in treatment practices

AgEcon Search: An International Disciplinary Repository

4th International Conference on Open RepositoriesThis presentation was part of the session : Conference PresentationsDate: 2009-06-04 08:30 AM – 10:00 AMAgEcon Search, http://ageconsearch.umn.edu, is a discipline-oriented repository, started in 1995, which includes working papers, conference papers and journal articles in the field of applied economics. Running on DSpace, it is housed at the University of Minnesota and coordinated by two librarians. Involvement of professional associations has been critical in its success, and other contributors include academic departments, government agencies and NGOs. Over 32,000 documents are included, from 170 groups in 35 countries.Farm Foundation; Agricultural and Applied Economics Association Foundation; USDA Economic Research Servic

Validating a dynamic population microsimulation model: Recent experience in Australia

Available published research on microsimulation tends to focus on the results of policy simulations rather than upon validation of the models and their outputs. Dynamic population microsimulation models, which age an entire population through time for some decades, create particular validation challenges. This article outlines some of the issues that arise when attempting to validate dynamic population models, including changing behaviour, the need to align results with other aggregate ‘official’ projections, data quality and useability. Drawing on recent experience with the construction of the new Australian Population and Policy Simulation Model (APPSIM), the article discusses the techniques being used to validate this new dynamic population microsimulation model.Dynamic microsimulation, validation, model output, usability

READING THE WORLD OF WORK: A LEARNER-CENTRED APPROACH TO WORKPLACE LITERACY AND ESL

As the title of this book suggests, Gallo advocates a learner-centredapproach in framing workplace literacy programs. She claims that such anapproach can change conventional notions of workplace literacy, improvecommunication practices throughout enterprises and help adult learnersrealise they have acquired much useful information in their lives that can bebuilt on in their workplace learning. In addition, through further learningusing learner-centred methods, they will be able to ‘transform’ rather than‘adapt to’ conditions in their workplace

Explicating Literacy Activities at Work: The use of ‘okay’ as an effective topic-changing device in service request calls

There is evidence from different spheres that the grounding of understandings of literacy within social practices has gradually become accepted within the adult literacy field in Australia. However, what has been not been sufficiently considered are those tacit literacies that underpin such practices in both everyday and work settings. This has been the case particularly for those literacies that are deployed through an oral communication mode in workplaces. This article offers a way of explicating such literacies by showing how the analysis of an audio-recording of a particular occupational activity, namely the reporting of a service request, can render visible particular key literacy features. In this case, such an analysis shows how the marker ‘okay’ is used in a critical way to close off segments of an interaction and to mark verbally that agreement about a particular aspect of the request has been reached.  It is argued that the use of recordings, both audio and video, for the purpose of highlighting tacit competencies has implications not only for adult literacy teachers but for trainers, assessors and curriculum developers within the broader vocational education and training sector

How do first graders define a family?

The goal of this study was to determine how first grade students define a family. Qualitative research was used as the methodology for this inquiry. The participants were thirteen first grade inclusion students in a school that is located in Southern New Jersey. An instructional unit depicting various family constellations was implemented along with authentic discussions, a student survey, an interactive bulletin board, a classroom library containing family books, and writing prompts contained in My Family Journal. The data collected and analyzed was from student discussion, the subjects\u27 work, direct observation of pupils, the instructional unit, and a teacher research journal. It was found that the first graders define a family by love, skin color, and co-habitation although they were able to recognize that some family members can live in different places. Repeated use of the family terms would help in future instruction along with broadening the scope of family dynamics to include those with same-sex parents

Maine Farmers\u27 Perspectives: Barriers and Optimism to Providing Food to Feed Maine People, A Qualitative Study Using Focus Groups

Maine has a history and tradition of agriculture in the state. Some growth in the number of farms in recent years has been due to youth entering agriculture, and in the development of small, diverse farms. There is also public interest in purchasing fresh, local foods. This study was done in conjunction with a University of Maine Cooperative Extension study that assessed Maine farmer’s views of the future of farming in Maine. The farmers (n=189) participated in one of twelve focus groups held across the state and represented a broad sector of Maine agriculture, including vegetable and fruit growers, beef and dairy producers, organic and conventional growers, and farmers with both large and small farming businesses. They were asked a specific series of questions, and their responses were recorded, transcribed, and analyzed for content related to their ability to provide food to feed Maine people. Farmers identified numerous barriers preventing them from providing food to feed the Maine population, yet their optimism for farming and the future was evident. Barriers to providing food for the population were summarized in the difficulty making a profit considering farmland costs and maintenance, and adhering to regulations. Lack of processing and distribution infrastructure was identified as a major barrier as well. In response to whether they had the ability to grow enough food to feed Maine people, the response was affirmative, but farmers expressed the need for support in order to do so. They named the need for infrastructure, ways to overcome the short growing season, and the population’s willingness to eat regionally as barriers to overcome in order to feed the Maine population. Beyond the ability to provide fresh, nutritious food, farmers provide the potential for economic development in a variety of sectors, such as research, education, tourism, infrastructure, retail, and marketing. When considering the future of providing food for Maine people, the farmers in this study optimistically voiced simple, but profound statements, such as, “Farmers make life possible,” and “We all have to eat.” They envision Maine farmers working in unity to feed others and to grow the economy: “Maine can be the breadbasket of New England ... by working together, whether we’re conventional, organic, permaculture ... we all wanna’ grow food.” Policy makers should take notice of what may be Maine’s greatest natural resources - farmers, and the food that can be produced from our land