title: Creating a diabetes foot reminder-based registry using the electronic medical record.
abstract: OBJECTIVE
  We created a new diabetes foot examination clinical reminder to directly populate a foot risk registry and examined its accuracy versus administrative data.
  
  
  METHODS
  A pre- and post-test design assessed accuracy of coding foot risk and clinician acceptability.  The intervention hospital's reminder was replaced with a dialogue tick box containing the International Diabetic Foot Classification System to populate risk using health factors.
  
  
  RESULTS
  There were no hospital agreement differences for each foot condition except diabetes and peripheral  neuropathy, demonstrating higher agreement at the intervention hospital. There were no differences in service agreement adherence or consulting rates although both demonstrated significantly lower consulting rates at study end. The intervention hospital had a significantly lower patient cancellation  rate (1% v. 5%, P=0.01) and better coding for grade 3 patients. The new reminder demonstrated high acceptability.
  
  
  CONCLUSIONS
  The registry system resulted in improved discrimination of the highest foot risk. Further testing is recommended.
authors: James A Lovell Federal Health Care Center, North Chicago, IL, USA. jswrobel@med.umich.edu
authors: James S
authors: JS
authors: Wrobel
authors: William
authors: W
authors: Chagares
authors: Rodney M
authors: RM
authors: Stuck
authors: Frances
authors: F
authors: Weaver
authors: Ryan T
authors: RT
authors: Crews
authors: Lauren
authors: L
authors: Rapacki
authors: Rhonda
authors: R
authors: Paulson
authors: David G
authors: DG
authors: Armstrong
mesh_terms: D000671:Amputation, Surgical / Q000592:standards / Q000706:statistics & numerical data; D059019:Clinical Coding / Q000592:standards*; D017719:Diabetic Foot / Q000145:classification / Q000517:prevention & control* / Q000628:therapy; D057286:Electronic Health Records / Q000458:organization & administration* / Q000592:standards; D006787:Hospitals, Veterans / Q000592:standards; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning / Q000458:organization & administration* / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration; D012042:Registries; D017010:Reminder Systems / Q000592:standards* / Q000639:trends; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D014481:United States