McMaster University

McMaster University

Faculty of
Health Sciences

Managing doctors’ practices made easier with new software tool

By Suzanne Morrison
Published: November 23, 2009
Rolf J. Sebaldt
Rolf J. Sebaldt

A McMaster University-led research team has developed an innovative software tool that gives family doctors up-to-date information on their patients in two seconds or less.

The tool, developed by a team from McMaster and Fig. P Software Incorporated, provides the "missing link" that’s needed to keep more patients with chronic illnesses — such as diabetes, heart failure and cancer — up-to-date with their health care. Called the Chronic Disease Management System (CDMS), it also tracks patients who forget to return to their doctor for follow-up visits.

Project director Dr. Rolf J. Sebaldt, associate clinical professor of medicine and clinical epidemiology and biostatistics, said physicians and their care teams face the overwhelming logistical challenge of ensuring patients with one or more chronic diseases are regularly monitored with everything from cholesterol tests and blood pressure checks to eye examinations.

One family doctor with a 2,000 patient roster might have 180 diabetic patients to track on a regular basis. "The doctor needs something outside of electronic medical records which have nothing to do with managing a whole practice. But, a chronic disease management system (CDMS) is a tool that lets a doctor looks at their whole practice."

Using the CDMS, once a week or once a month, a doctor or his staff can view the needs of all 2,000 patients "but, more interestingly, see their 180 diabetics, their 272 patients with high blood pressure, their 212 mammogram-eligible women, and sort them — not just alphabetically — but also in terms of dates or by numerical results," he said.  "All the most overdue patients show up right at the top.  With the click of a button, and instantly within two seconds or less, you get these very helpful lists with names, phone numbers, dates and results of the last test."

A colour-coded system identifies where patients are at with their various tests, such as red for those most overdue and green for those patients who are up-to-date.  The CDMS has care plans built in for each chronic disease which offers doctors a choice of evidence-based management and treatment guidelines to follow.

Sebaldt said the CDMS improves patient care by "giving physicians instant visibility over the status of all their patients at one glance (which) empowers and enables them to see what is going on, ensuring better care for every patient in their practice."

CDMS is being used in Ontario by over 65 physicians with a total of 115,000 patients.  A basic one year subscription costs $2,300.

Three studies are currently evaluating the CDMS: A Ministry of Health Technology Assessment study is investigating whether or not it will improve diabetes care; a masters student at McMaster is studying the system’s value in improving smoking cessation counseling; and diabetes specialist Dr. Hertzel Gerstein has adopted the CDMS for use and further evaluation in his diabetes clinic at McMaster.

The CDMS was developed by a diverse team that includes physicians, a software architect, computer programmers and others.

The team was recently a finalist for the Ontario government’s 2009 Innovation Award in its Innovations in Health Information Management category. The award is one of six given by the Ministry of Health and Long Term Care (MOHLTC) as part of the ministry’s Innovations in Health Care Expo 2009, which showcases leading initiatives underway in the province to improve health care services.

This honour is a repeat recognition of the team’s innovative work. Two years ago, Sebaldt’s team won an Ontario Health Minister’s Innovation Award for their creation of P-PROMPT, a software program that alerts doctors about patients who are overdue for cancer screening.

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