Rhode Island Prevention Connection
Your resource for optimizing the use of your electronic health record (EHR) system to improve the quality and frequency of preventive health care services |
CDC Health Alert: Pneumococcal Vaccine
Some of the CDC's Active Bacterial Core surveilance (ABCs) sites have seen greater than expected numbers of cases of invasive pneumococcal disease coincident with increases in influenza-associated hospitalizations. Influenza predisposes individuals to developing bacterial community-acquired pneumonia. During each of the influenza pandemics of the 20th century, secondary bacterial pneumonia was a frequent cause of illness and death and S. pneumoniae was reported the most common etiology. These findings also apply to seasonal influenza. Recently, pneumococcal infections have been identified as an important complication in severe and fatal cases of the H1N1 influenza virus infection.
The evidence outlined above supports the importance of immunizing our elderly and high risk population against pneumonia. To link to the latest CDC recommendations and read the article in its entirety, click here. |
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Doctor's Corner
by Christopher Campanile, MD, PhD
Chemoprophylaxis & Treatment in Persons with Seasonal & H1N1 Flu
 The CDC has recently published Interim Guidelines for chemoprophylaxis and treatment in persons with seasonal and H1N1 influenza infection. The information in this month's column is taken from those guidelines. As you know, those at high risk for complications from influenza infection (children younger than 2 years, adults 65 years or older, pregnant women, persons with immunosuppression, disorders compromising respiratory tract function or handling of respiratory secretions or increasing risk for aspiration, or chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematologic (including sickle cell disease), or metabolic diseases (including diabetes mellitus) may benefit most from early treatment with antiviral medications.
In addition to pregnant women, those up to 2 weeks postpartum or after a miscarriage are now included as being at increased risk for complications from 2009 H1N1 influenza. It is also worthwhile to educate our high risk patients, who are at higher risk for influenza complications, about the signs and symptoms of influenza and the need for early treatment, should they come down with an influenza-like illness. This educational piece could become part of the chronic illness visits that these patients already have scheduled during the current flu season. In addition, these patients and those who report severe illness, should have rapid access to telephone consultation and clinical evaluation. Empiric treatment based on telephone contact may be considered for patients at higher risk for influenza complications, if hospitalization is not needed, and if this will result in markedly less delay before treatment is initiated.
Consideration for antiviral chemoprophylaxis should usually be limited to individuals at greater risk for influenza-related complications who have been exposed to someone likely to have been infected with influenza. After a suspected exposure, however, early treatment may be an option vs. chemoprophylaxis. Nausea and vomiting are a possible side effect of oseltamivir.
Click here to see the oseltamivir dosing recommendations for children younger than 1 year.
Click here to view the article in its entirety and access cited references. |
In the News
H1N1 Vaccine Clinics in Rhode Island
Flu information and recommendations for seniors:
The Rhode Island Department of Health has developed updated flu-related information and recommendations for citizens of all ages. In Rhode Island, it is expected that the H1N1 vaccine will be available to seniors in mid-January at public clinics. Actions that seniors can take to stay healthy this flu season include getting their seasonal flu and pneumonia vaccines and seeking medical advice quickly if they develop flu symptoms. Click here for more information on immunizations for seniors.
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Prevention Update
The Prevention Team at Quality Partners of Rhode Island is in the process of meeting with the practices in the Power Up for Prevention project to share their Quarter 5 (August through October) data. We are contacting the offices to arrange monthly meetings in which we plan to share best practices, assist you with overcoming any barriers you have encountered, and share your data with you.
Our hope is to benchmark de-identifiable data within each practice and eventually across the project with those who wish to participate in that process. Thank you for your continued participation. |
Sharing Best Practices
The completeness of your patient's EHR can be augmented with a small change in workflow. Having the MA/nurses ask the patient if they have received the influenza vaccine outside the office and then documenting that information into the discrete data field of the immunization screen or health maintenance screen will do just that! They can also check to see if the patient is appropriate for the pneumonia vaccine at the same time and initiate that process. The prevention team has created posters to remind patients to notify you if they have received the vaccine elsewhere. Please let us know if you would like some for your office. Keep up the great work!
Please contact us with your best practices and we will share your successes in our newsletter. | |
This material was prepared by Quality Partners of Rhode Island, the Quality Improvement Organization for Rhode Island, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. | |
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Quote of the Month
There is nothing permanent except change.
~Heraclitus
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Tip of the Month
Free professional housekeeping services are available to female patients undergoing cancer treatment.
The cleaning service provides FREE housecleaning - 1 time per month for 4 months while she is in treatment. All the patient has to do is sign up and have her doctor fax a note confirming the treatment. Cleaning for a Reason will have a participating maid service in her zip code area arrange for the service.
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Events
There are no local events scheduled for December.
`Happy Holidays!`
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Tools
Patient Education Brochures
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Medicare Quick References
EHR Tools
eClinicalWorks
EpiChart
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Feedback Requested
Thank you for your commitment to quality.
If you have questions or comments or require technical assistance on the Power Up for Prevention Project, please contact
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