Implementing Quality Improvements at a Group Practice

THE PRACTICE

Westgate Medical Group is a nine-physician internal medicine practice in Milwaukee, WI.

THE PROJECT

Westgate uses Total Practice Partner in their practice. This fully integrated software package includes Practice Partner Patient Records, Order Entry, Appointment Scheduler, and Medical Billing. Westgate is also a member of the Practice Partner Research Network (PPRNet), a practice-based research network linking physicians using Practice Partner Patient Records.

Westgate's providers place a strong emphasis on incorporating quality improvement measures into their practice. Progress note templates in Practice Partner Patient Records are essential tools for incorporating these measures into the provider's daily workflow, so that tracking and managing quality is an integrated part of daily practice. Examples include:

• Making relevant clinical information readily available during the encounter. Practice Partner's note templates will automatically insert chart data such as recent lab results (e.g. Hemoglobin A1C for diabetics) and overdue health maintenance items.

• Requiring actions by the provider. For example, the progress note templates require a discussion of statins and anti-platelet therapy with all patients that have diabetes or coronary artery disease.

• Embedding decision support or care reminders. The providers add and update guidelines from sources such as the American Diabetes Association, National Cholesterol Education Program, US Preventive Services Task Force, and others.

THE RESULTS

Westgate's providers have made marked improvements to quality of care based on a number of measures including:

• Proportion of hypertensive patients using anti-platelet therapy rose from 15% to 65%. - Percentage of diabetic patients with a BP less than 130/80 increased from 29% to 56%. - Proportion of diabetic patients with a Hemoglobin A 1 C less than 7 improved from 45% to 60%.

CONCLUSION

Implementing quality improvements across a group practice often presents challenges. Westgate was successful because, using Practice Partner progress note templates, the providers were able to make quality a standard part of their daily practice-not an extra task that requires additional work or management. This has enabled them to achieve sustained quality improvement.