title: eMAP:CKD: electronic diagnosis and management assistance to primary care in chronic kidney disease.
abstract: The increasing burden of chronic kidney disease (CKD) underpins the importance for improved early detection and management programs in primary care to delay disease progression and reduce mortality rates. eMAP:CKD is a pilot program for primary care aimed at addressing the gap between current and best practice care for CKD.
  
  
  
  Customized software programs were developed to integrate with primary care electronic health records (EHRs), allowing real-time prompting for CKD risk factor identification, testing, diagnosis and management according to Kidney Health Australia's (KHA) best practice recommendations. Primary care practices also received support from a visiting CKD nurse and education modules. Patient data were analyzed at baseline (150 910 patients) and at 15 months (175 917 patients) following the implementation of the program across 21 primary care practices.
  
  
  
  There was improvement in CKD risk factor recognition (29.40 versus 33.84%; P < 0.001) and more complete kidney health tests were performed (3.20 versus 4.30%; P < 0.001). There were more CKD diagnoses entered into the EHR (0.48 versus 1.55%; P < 0.001) and more patients achieved KHA's recommended management targets (P < 0.001).
  
  
  
  The eMAP:CKD program has shown an improvement in identification of patients at risk of CKD, appropriate testing and management of these patients, as well as increased documentation of CKD diagnosis entered into the EHRs. We have demonstrated efficacy in overcoming the verified gap between current and best practice in primary care. The success of the pilot program has encouraging implications for use across the primary care community as a whole.
authors: Department of Nephrology, Western Health, Melbourne, VIC, Australia.
authors: Aspasia
authors: A
authors: Pefanis
authors: School of Public Health, Department of Medicine, Monash University, Clayton, VIC, Australia.|North West Academic Centre, The University of Melbourne, Melbourne, VIC, Australia.
authors: Roslin
authors: R
authors: Botlero
authors: Monash Rural Health, Monash University, Clayton, VIC, Australia.
authors: Robyn G
authors: RG
authors: Langham
authors: Department of Nephrology, Western Health, Melbourne, VIC, Australia.|North West Academic Centre, The University of Melbourne, Melbourne, VIC, Australia.|Sunshine Hospital, 176 Furlong Road, St Albans, VIC, Australia.|Western Chronic Disease Alliance, Sunshine Hospital, 176 Furlong Road, St Albans, VIC, Australia.
authors: Craig L
authors: CL
authors: Nelson
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D019468:Disease Management; D018450:Disease Progression; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000458:organization & administration*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*
keywords: chronic kidney disease; e-health; electronic health record; primary care; technology