447 Improving the quality of care in systemic lupus erythematosus (sle) through time-structured, information technology-enhanced, quality improvement indicator-driven patient management

Background and aimsGaps exist in SLE patient care at Ochsner Health System (Ochsner) related to both A) monitoring and management of comorbidities and treatment-related toxicities and, B) monitoring and management of disease activity. The uncovered gaps suggested a lack of well-defined systems of care in SLE within Ochsner that lead to a “looser” overall management of SLE patients than is optimal. Our hypothesis was that a more time-structured, IT-enhanced, and QI indicator-driven approach to SLE patient management would translate into a more frequent, more comprehensive, and guideline-adherent interaction with the patient (i.e. “tighter” management). This “tighter” management, we hypothesised, would manifest as improved patient outcomes.MethodsIn order to prompt “tighter” management, we implemented the following interventional modalities:Lupus Management Module: An SLE-specific management dashboard programmatically embedded into the Epic EHR system in use at Ochsner. The dashboard incorporates SLE-management-specific reminders, alerts, historical test result tracking, and customised assessment (SLEDAI, SLICC) programming.Patient Campaigning: Identification of patients who are due for various SLE-specific testing or management activities and proactive contact in order to prompt an office visit.ResultsWe demonstrated a “tighter” management of SLE patients through statistically significant improvement in the rate of key SLE management behaviours (95% CI).Abstract 447 Table 1“Tighter” management, in turn, prompted statistically significant improvement in hospitalisation (85% CI).Abstract 447 Table 2ConclusionsTime-structured, IT-enhanced, and QI indicator-driven interventional modalities prompted a more frequent, more comprehensive, and guideline-adherent point of care interaction with SLE patients (i.e. “tighter” management). “Tighter” management manifested as improved patient outcomes in the form of a diminished rate of hospitalisation among SLE patients.