Abstract: TH-PO539

Electronic Health Record (EHR) Based Pre-ESRD Chronic Kidney (CKD) Registry in the Intermountain West as a Clinical Tool

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 307 CKD: Health Services, Disparities, Prevention

Authors

  • Srinivas, Titte, Intermountain Medical Center, Murray, Utah, United States
  • Edgel, Denney, Intermountain Medical Center, Murray, Utah, United States
  • Hamilton, Sharon, Intermountain Medical Center, Murray, Utah, United States
  • Greenwood, Mark R, Intermountain Medical Center, Murray, Utah, United States
  • Hadley, Steve, Intermountain Medical Center, Murray, Utah, United States
  • Larson, Katie, Intermountain Medical Center, Murray, Utah, United States
  • Morales, Ray, Intermountain Healthcare, Murray, Utah, United States
Background

The field of kidney disease is richly endowed with data sources. However, data are lacking on pre-End-Stage Renal Disease (ESRD) CKD especially at a granular level in the context of clinical care. Such data can be used to drive optimal care delivery in the clinic. We report on an EHR based CKD registry built at a large integrated health system in the Intermountain West that captures longitudinal patient level data as well as payer information from diverse sources. The scope of this registry encompasses 5 states, 179 clinics, 22 hospitals and 800,000 lives under a private payer and 2 million lives overall.

Methods

Patients were acccrued to this pre-ESRD CKD registry based on estimated GFR (eGFR), ICD 10 codes, CPT codes, EHR comorbidity data, prescription data, drug names and doses, laboratory data and claims data. Results were cross validated by eGFR and claims data. The registry was built off an Enterprise Data Warehouse that has been extant since 1990. A subset of patients recieved birth to death care within this Integrated Health System. Data from this registry are use to track quality and care delivery in real time with EHR advisories to drive care in the clinic as well as serving as vehicles to update care process modules based on accrued outcomes.

Results

Results are depicted in Figure 1. A total of 97877 patients with pre-ESRD CKD are included with a White predominance; 96.4 percent of patients in Stages 1 through 5 and CKD 2-4 comprising 81.6 %. Early stage CKD showed a male preponderance. The Registry was able to provide classification by demographics (a)and comorbidity (b) , as well as by CKD Stage and Payer type (c) and BP control/ ACEI/ARB use (d) on a real time basis. Overall, BP was deemed controlled in 34.6 % and ACEI/ARBs were used in 25.5%.

Conclusion

We demonstrate the utility of an EHR based CKD Registry with Longitudinal Real Time Follow up as way to optimize pre-ESRD CKD care in a Large Integrated Health System.