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Specialists, this One’s For You: Preventive Care Reminders Broken Down by 8 Specialties

by Allison LaValley, Executive Director of Clinical Performance

After my blog post in September, “Putting Six Months of Meaningful Use Stage 2 Data to Use,” I heard from providers asking show their particular specialty can meet the Preventive Care Reminders measure of Meaningful Use Stage 2. For primary care providers, meeting this measure seems like a slam dunk. There are endless opportunities to send patients a care-related reminder, from evidence-based preventive health clinical care guidelines — such as vaccines and annual wellness visits — to an array of general health and wellness activities, like those related to nutrition and fitness.

But for specialists, meeting this measure is not as straightforward, and many are struggling to meet the threshold. That’s where we can help! Our Meaningful Use task force (yes, that’s a thing here at athenahealth) has compiled long lists of the ways specialties can meet the Preventive Care Reminders measure and we’re happy to share that knowledge with everyone.

First things first: To meet this Meaningful Use requirement, remember that you must use clinically relevant information from your Certified Electronic Health Record Technology (CEHRT). And, these reminders must be for preventive or follow-up care the patient isn’t already scheduled to receive. So, where should you start?

Regardless of your specialty, we recommend you use your certified EHR to identify patients who need a certain type of care and haven’t yet received it. For example, in our athenaClinicals EHR, providers can set a ‘Return to Office’ reminder during a patient visit, identifying a future time for the patient to return for follow-up care. Your practice should also reach out to any patients who have been flagged as needing a future appointment, but don’t yet have one.

What’s next? We recommend leveraging the quality management tools in your EHR to identify patients who have gaps in care, such as uncontrolled blood pressure in patients with hypertension or colorectal cancer screenings. If your EHR doesn’t offer guidelines relevant to your specialty, or if you’re looking for additional ideas, here are some great reasons to reach out to patients and keep them healthy.

All specialties

  • Smoking Cessation: Provide information on tobacco cessation and smoking risks, targeted at patients who smoke (based on smoking status in CEHRT). Consider varying the message: Highlight increased risk of heart disease, challenge patients to “pick a quit date,” or share information about support groups.
  • Heart Health: Increase awareness of the link between LDL and heart disease and stroke.
  • Health Awareness: Promote maintaining a healthy weight, being active every day, drinking only in moderation and avoiding smoking; encourage breast and cervical cancer screenings for women, and general check-ups for men.

Allergy & Immunology

  • Allergy Season: Remind patients to contact your practice for allergy assessment and treatment.
  • Asthma: Remind patients to use their inhalers and take other medicines as prescribed, and to avoid triggers, especially during allergy season.

Cardiology

  • Vaccines: Remind patients with chronic heart disease to get their pneumococcal vaccine.
  • Lifestyle modifications, such as diet and weight management: Provide information on the DASH diet; encourage patients to see a registered dietitian; recommend 30 minutes a day of exercise and give examples of physical activities.
  • Congestive Heart Failure (CHF) patients: Stress the importance of daily weight monitoring weight to prevent exacerbations and/or hospitalizations.
  • Patients on Warfarin: Remind patients about the importance of regular INR tests, Vitamin K sources in diet, and being careful about alcohol intake; educate on new or alternative treatments.

Dermatology

  • Sunscreen: Remind patients about safe sun behavior (this is important even after the end of summer).
  • The ABCDEs: Stress the importance of skin cancer evaluation and remind patients of the ABCDE signs of melanoma.

Otolaryngology

  • Bright Futures Guidelines (AAP) Increase awareness of early hearing evaluations for children at birth, with a rescreening for kids with one or more risk factor by 24-30 months of age.

Pediatrics

  • Concussion prevention for biking and other sports: Increase awareness of head injury signs and symptoms. Provide resources for baseline and post-concussion ImPACT testing.
  • Poison Control: Increase awareness about poison exposures and provide phone numbers for the Poison Control center (1-800-222-1222).
  • Pediatric dental exams: Promote early dental screening/hygiene appointments, starting at 12 months of age. Encourage good dental hygiene and appropriate water fluoridation.
  • Nutrition and BMI: Promote weight management through a healthy, balanced diet, including portion control and minimal sugary beverages; promote exercise and limited screen time; encourage family engagement.
  • Adolescent substance abuse: Increase awareness of signs/symptoms of substance abuse in teens (including prescription drug abuse), and provide local community resources and online resources.

Surgical specialties

Any time:

  • Fall prevention (for patients 65+): Promote regular activities such as walking, swimming, tai chi to improve balance and coordination, and build muscle strength. Encourage a home assessment to eliminate potential fall hazards.
  • Stretching: Promote awareness of the need for stretching to promote flexibility, and decrease risk of sprain, strain, ligamentous tear or other injury.

Post-Op:

  • Recovery education: Remind patients to continue post-op and chronic meds; promote post-op infection awareness and prevention.

Urgent Care

  • Patients recently diagnosed with chronic conditions: Remind patients to follow-up with their primary care provider if symptoms don’t improve.
  • Patients recently prescribed antibiotics: Encourage medication adherence. Tell patients to take full course even if your symptoms subside.
  • Patients recently treated for wounds: Provide education on ways to avoid infection, and remind patients when it is time to get sutures removed.
  • Patients with acute asthma exacerbations: Remind patients to follow up with their primary care provider and follow asthma instructions.
  • Sprains/strains: Recommend rest, ice, compression, elevation (RICE), plus stretching and strengthening exercises to prevent further injury.

Gastroenterology

  • Post-bariatric surgery: Encourage patients to follow their prescribed diet plan, e.g., eat small frequent meals, take daily vitamins and mineral supplements, avoid high fat/sugar foods.
  • Patients diagnosed with IBS: Encourage patients to keep a diary of symptoms including frequency, triggers, and food eaten. Remind patients to eat slowly, drink plenty of water each day and exercise regularly.

This is just a small sampling of the Preventive Care Reminders you could use for various specialties. And we hope it helps! We’d love to hear how your practice has approached this challenging measure, so please share more ideas with us in the comments section.

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