Abstracts

Rationale: Epilepsy Quality Metrics (EQMs) include the systematic assessment of seizure frequency and type. While the use of EQMs is expected to improve health outcomes, in clinical practice, standardized documentation at a site has been challenging due to variability in providers’ data reporting methods. We evaluated the feasibility of completing and collecting structured documentation of this EQM as part of the ongoing implementation of the Epilepsy Learning Healthcare System (ELHS) in our center. The ELHS is a patient-centered network composed by academic universities, patient representatives, and non-profit organizations that uses health data information to learn from patient care, while iteratively designing, testing, and implementing interventions to improve health care delivery. Methods: This was a prospective cohort study. Five participant providers aimed to collect standardized clinical data (e.g., standardized epilepsy diagnosis, seizure type, and frequency classification) as part of routine clinical care for all (n=279) adult patient-encounters from 01/20/2019 to 05/11/2019 (16 weeks) in a tertiary-referral, epilepsy clinic. A Smartphrase template was designed for the structured collection of seizure frequency and type, as defined by the International League Against Epilepsy (2017). We assessed provider EQM Smartphrase completion rates as a measure of standardized documentation feasibility. We also linked this clinical data to social determinants of health, and we used χ2 test of independence and Mann-Whitney U Test to identify any demographic differences between patient encounters where EQM Smartphrase was or was not completed and to define the clinical characteristics of the patient encounters with completed EQM Smartphrase. Results: ELHS-participating providers conducted 279 clinic appointments with an 81% completion rate (226 encounters) of EQM Smartphrase. Of these 262 unique patients, there were no differences in age, gender, primary language, or ethnicity between patients for encounters with and without standardized EQM documentation. (Table 1). Among encounters with completed Smartphrase documentation, 92% of encounters were for patients with the diagnosis of epilepsy. These patients reported focal and generalized seizures in 56.2% and 41.6% of visits, respectively. 58.8% of encounters, patients reported one seizure type while 33% reported more than one seizure type. 61% of EQM Smartphrase encounters revealed the presence of active epilepsy, as defined by a seizure frequency of more than one per year. Lastly, 50.9% and 61.5% of patients had seizures within the last three and six months, respectively (Table 2). Conclusions: Systematic, standardized documentation of seizure frequency and type is feasible and representative of the target population of a busy tertiary clinic. This is the first step towards a better understanding of our epilepsy population characteristics and needs. Funding: No funding