Featured Practice: Western Kentucky Rheumatology — Increased BMI Screenings


This week’s featured practice is Western Kentucky Rheumatology. Over the course of TCPI, this practice has increased its BMI screenings by 35%. Their story shows the importance of having the right technology to support continuous quality improvement

Western Kentucky Rheumatology is a single physician practice with offices in Clarksville, Tennessee and Hopkinsville, Kentucky. With a small support staff including a medical assistant, receptionist, and billing specialist, this practice has embraced QI methods like the Model for Improvement and PDSA cycles to get optimize their processes, team roles, and overall patient care. 

Obesity trends are high across the United States, but especially in Kentucky, which has the eighth highest adult obesity rate in the country. Joint health is exacerbated by obesity— excess weight puts pressure on joints and can create additional burdens for individuals at risk of developing or already managing joint diseases like rheumatoid arthritis. Recognizing this, the practice decided to initiate a systematic BMI screening program

The first step was to incorporate patient weighing into the workflow. Next, the focus was on ensuring proper documentation in the EHR. During this process, the practice learned their EHR had ceased to provide a function to track documentation and progress over time– making it impossible to know if their process improvements were having an impact. With the assistance of TCPI, the practice brought in an analyst who determined an alternative method to monitor data. They identified an EHR add-on to remedy the problem moving forward.   

With the new data monitoring system in place, the practice has seen the results of their process changes. Baseline BMI reporting was 36%, and after two years it has doubled to 71%. BMI screenings and follow ups are now a routine part of patient care. You can read more about Western Kentucky Rheumatology’s transformation story here.  

It is a near universal experience that when a practice begins to work on quality improvement, there is a gap between what the data say and what the practice assumed the data would say. We discuss this reality and tips for data management on “The Practice of Improvement: Part 2” of the MidSouth PTN “Best Practices” podcast.  

The views expressed in this story are those of the authors and do not necessarily represent the official views of Western Kentucky Rheumatology. Additionally, this work was funded by the U.S. Department of Health and Human Services – Centers for Medicare and Medicaid Services’ Transforming Clinical Practice Initiative, under grant number 1CMS331549-03-00. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.


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