Computerized condition-specific templates for improving care of geriatric syndromes in a primary care setting

INTRODUCTION: As the U.S. population ages, primary care clinicians (PCCs) will encounter more patients with geriatric syndromes, such as urinary incontinence (UI) and falls. Yet, current evidence suggests that care of these conditions does not meet expected standards and that PCCs would benefit from tools to improve care of these conditions. Little is known about the role of computerized condition-specific templates for improving care of geriatric syndromes. AIM: We sought to develop and assess the usefulness of condition-specific computerized templates in a primary care setting. SETTING: A large academic Veterans Affairs medical center. PROGRAM DESCRIPTION: We developed and tested the usefulness of 2 condition-specific computerized templates (UI and falls) that could be added on to an existing electronic health record system. PROGRAM EVALUATION: Semistructured interviews were used to identify barriers to use of computerized templates. Usefulness and usability were assessed through a randomized-controlled trial involving standardized patients. DISCUSSION: Use of condition-specific templates resulted in improved history and physical exam assessment for both UI and falls (P<.05). Our computerized, condition-specific templates are a promising method for improving care of geriatric conditions in a primary care setting, but require improvement in usability before widespread implementation. She recognizes the support of members of the Older Americans Independence Center (OAIC) External Advisory Committee and Emmett Keeler, PhD. Finally, Dr. Fung recognizes the time and effort of C. Alex Terry in the West Los Angeles CPRS Support Office, who helped program the computerized templates, and Colletta Austin, MA, in the CPRS Support Office, who set up the test server accounts for the project. The views expressed in this article are those of the author and do not necessarily reflect the position or policy of the Department of Veterans Affairs. Funding: This research study was supported by the UCLA Claude D. Pepper Older Americans Independence Center, NIH Grant P60 AG10415. Commercial Associations: Dr. Fung is a staff member on a project funded by Pfizer and is a staff physician at the West Los Angeles VA Medical Center.