Dr El Karsh practices family medicine in the community of Qualicum beach on Vancouver Island.
In recent months, Dr. El Karsh decided to join the Health Data Coalition (HDC) to support his quality improvement efforts using HDC Discover. He found the application easy to use, complimented his Med Access EMR well, especially for seeing ‘at a glance’ areas that he felt needed some attention.
“I keep HDC Discover open on my desktop, so that I can easily check it when I have moment, looking for areas to improve,” says Dr El Karsh.
Dr El Karsh initially decided to focus on patients with Diabetes and Chronic Kidney Disease (CKD), as both groups qualify for Complex Care plans. For his CKD patients, he saw at-a-glance in HDC Discover that the documented prevalence of these patients was far lower than he thought it to be. With the support of his Practice Support Program coach Suzanne, Dr El Karsh ran queries in Med Access and found that most of his patients were documented as having kidney disease based on GFR results, which is less sensitive than ACR. Looking at the ACR results, he realized there may have been more chronic kidney disease patients that needed to be documented in the problem list. The problem list is how HDC Discover captures this information. This then provided him with what he needed to adjust the records for these patients, thereby meeting MSP criteria for Complex Care as well as planning for the time commitment that these patients need.
For his diabetic patients, Dr El Karsh took a closer look at LDL testing completed in the last 5 years. With HDC Discover he was able to view his aggregate data in comparison with Vancouver Island and the Lower Mainland and felt that he could do better. For him, this really changed how he approached care for these patients. Again, working with Suzanne, Dr El Karsh ran queries on all diabetic patients who had not had LDL checked in the last 5 years. He then requested the test and scheduled care plan visits with each of them. As a direct result of this work, Dr El Karsh developed improved patient lab tests along with closer monitoring of this patient group.
Dr El Karsh has kept busy with these quality improvement projects, and is finding the outcomes rewarding. What’s next for Dr El Karsh?
“I am now taking a look at patients with anxiety in my practice. On my HDC Dashboard I saw a lower prevalence of anxiety than anticipated and realized that I was using an outdated code in my EMR- 50B. My PSP coach Suzanne helped me pull all the patient records to appropriately code 155 patients as 300 for anxiety and 35 patients as 311 for depression.”
Dr El Karsh shares that this will help him move forward with appropriate mental health care plans and billing for these patients, as well as others he identifies in the process.