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Kidney Week

Abstract: FR-PO260

Associations Between Facility Use of an Electronic Patient Care Plan and Foot Check Rates in Dialysis Patients

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Millette, Wendy, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Electronic care plans have the potential to streamline the management of patient meetings to create, follow, and optimize patient centric interventions for unstable conditions. A large dialysis organization (LDO) deployed an electronic Plan of Care (ePOC) tool for clinicians to improve and personalize care coordination. We assessed if use of the ePOC tool by facilities was related to improvements in the percentage (%) of patients receiving diabetic foot checks.

Methods

The ePOC application was deployed at an LDO in October of 2017. We analyzed monthly data from dialysis patients that had the ePOC application used by the care team during October of 2017 (baseline) and October 2018. We selected the top 15% of the clinics performing the highest % of diabetic foot checks, and the bottom 15% of clinics performing the lowest % of foot checks. Of those, we selected the top and bottom 33% of the clinics with the highest and lowest use of the ePOC tool, respectively. We compared the difference from baseline in % of patients receiving foot checks between facilities with high and low ePOC usage stratified by high and low achievement of baseline foot checks.

Results

We included data from 2432 dialysis facilities. We selected 400 clinics with care teams who were the highest and lowest users of the ePOC tool. Clinics starting with a low or high % of foot checks that were high ePOC users had greater increases in the % of foot checks after follow-up compared to clinics with low ePOC usage (Figure 1).

Conclusion

Use of the ePOC system in the dialysis setting may be have the potential to lead to improvements in the workflow of care in conducting diabetic foot checks. Further analyses are needed to support these findings as these may be confounded by clinics that are more compliant with internal policies.

Funding

  • Commercial Support