A SINGLE COMMUNITY CENTER UNBLINDED CROSS-SECTIONAL STUDY ON SPIROMETRY OR PULMONARY FUNCTION TEST UTILITY OF PATIENTS INCLUDED IN THE COPD REGISTRY AT TERTIARY CARE COMMUNITY HOSPITAL

Abstract

SESSION TITLE: Obstructive Lung Diseases 1 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Spirometry or pulmonary function testing is required for the diagnosis of chronic obstructive pulmonary disease yet this practice is often not followed. An academic satellite tertiary care community hospital analyzed the effects of provider education on utilization of spirometry and deficiencies in the COPD registry. METHODS: An un-blinded cross sectional observational study quantified the summit educational intervention on provider practice while refining the COPD registry. By using filters and billing codes to clarify missing data, the EPIC electronic medical record applied data monitoring of compliance of formal COPD diagnoses with testing. RESULTS: In July 2017, the COPD registry at our hospital had 7,264 people involved. The number of pulmonary function tests were 1,795 before August 2017. In February 2018, there are 6858 people involved in the COPD registry and 1,932 have pulmonary function testing on file. The utilization of lung function testing has improved from 24% to 38% usage since the summit educational intervention. CONCLUSIONS: In conclusion, our hypothesis described that the pulmonary testing adherence percentage would increase after the educational summit meeting on lung function testing and COPD diagnosis while concurrently purifying the COPD registry. These results are possibly reflective of a typical community hospital practice. The accuracy of registry is important to report reliable mortality and readmissions data to Centers of Medicare & Medicaid Services. CLINICAL IMPLICATIONS: Chronic Obstructive Pulmonary Disease is pervasive in southwest Michigan. “Symptomatic COPD affects more than 5 percent of the adult population, is the fourth leading cause of death, and the twelfth leading cause of morbidity in the United States.” Patients are often added to the to the Chronic Obstructive Pulmonary Disease registry without formal diagnosis. Spirometry is required to make the diagnosis of COPD. The Global Initiative of Chronic Obstructive Lung Disease states FEV1/FVC ratio is necessary to describe the disease process. The spirometry measurements are the foundation for staging the disease according to GOLD criteria. Doctor Ferguson further proved trending the patients spirometry measurements was beneficial in reducing mortality. Interventions from primary care spirometry “Reduced the relative risk of exacerbations by 20 to 25 percent and the absolute risk by 5 to 6 percent.” In our community, spirometry is underutilized. Standard practice should be 100% compliance but as Dr. Bolton showed, spirometry usage is at 85.6% for COPD diagnosis and management. An area wide Summit educational seminar was held in July to address this utilization issue. This research is aimed to quantify the change made to the COPD registry including spirometry performed, patients remaining without spirometry, incorrect diagnosis and labeling and verification of registered members. DISCLOSURES: No relevant relationships by Brittany Haines, source=Web Response No relevant relationships by Furqan Shoaib Siddiqi, source=Web Response