Teresa Hodgkins Pharm'D'

1
Converting from CoumaCare to DAWN-AC V7

• Teresa Hodgkins Pharm.D.
• Director of Anticoagulation Center
• Desert Medical Group/Oasis IPA
• Palm Springs, California

2

• Knox-Keene licensed medical plan (full-risk)
  established 1981
• 80,000 lives (20,000 seniors)
• 100 primary care physicians
• Coumadin Clinic established 1996

3
Palm Springs, California, USA
4
Prior to DAWN-AC

• Closed enrollment capped at 650 pts
• Primary Care Physician responsible for new
  warfarin patients
• Resultant physician dissatisfaction
• High reliance on paper-based system
• Lost patient information
• Various lists maintained by 2 clerical personnel
• Each patient contacted by phone for lab results
  and instructions

5
How we used CoumaCare.

• Utilized by the anticoagulation service for many
  years
• Performed scheduling and some sorting of data
• Information was compiled in a running dialog
  format
• Had concurrent paper process

6
Conversion Process

• Only active patient data from CoumaCare was
  converted and placed into DAWN-AC by DAWN-AC
  programmers
• Resultant data was reviewed for accuracy and
  appropriateness by DMG/Oasis clinicians
• Adjustments/refinements were performed
• Overall process took months to coordinate

7
February 2006 Go Live!

• Most of the clinic staff had very little training
  on DAWN-AC prior to the Go Live date
• Brenda Nicol arrived to assist in the process
• By the end of day 2 we had a functional system
  used by all staff members

8
Utility of the List View

• Incredible flexibility
• Can be easily customized to your process
• Allows patient data to be sorted in many
  different ways
• Now we manage the data instead of allowing the
  data to manage us!

9
Now we can sort patients by

• Physician/Laboratory/Pharmacy
• Specific insurance type
• Acute care hospitalization with details
• Enrollment in special programs such as intense
  case management, living and aging well for frail
  elderly, and patients receiving home health
  services

10
Letters and DAWN-mailer

• Allow us to easily generate documents
• Fax via computer to a multitude of entities
• Save to patient file
• Virtually a paperless process

• Results/missed lab letters to patients
• Enrollment forms and patient summary reports to
  physicians
• Laboratory orders
• Any document we wish to create as the need
  arises

INR 2.5
11
Dosage Calculator

• Greatly assists in determining doses for patients
• Not a substitute for clinician but does aid the
  clinician
• Greater efficiency has allowed for more time to
  be spent on patient education and assessment

12
After Conversion to DAWN-AC

• Enrollment opened
• Marketing to PCPs for referrals
• Development of paperless process
• Stable patients receive letters with results and
  instructions
• Job functionality redesigned for clinical
  efficiencies

13
Today

• Since Go Live, we have added over 600 new
  patients (in 6 months)
• Total patient load is rapidly approaching 1000
• We evaluate approximately 450 PT/INR results per
  week
• Stable patients now receive letters for
  instruction

14
Results

• Physician satisfaction much improved. They are
  able to focus efforts on other aspects of patient
  care.
• Patient satisfaction with service remarkable (100
  patients surveyed-100 rated overall satisfaction
  either very satisfied or extremely satisfied)
• Anticoagulation Center Director named Manager of
  the Year!

15
Future Goals

• Use DAWN-AC to better measure and demonstrate the
  quality of our service
• Participate in benchmarking program
• Apply the clinical model for the anticoagulation
  service to other aspects of disease management
  for the patients of DMG/Oasis IPA (The door is
  open)

16
Thank You