You already know about the dangers of high cholesterol, high blood pressure, and smoking. Your patients may too. But you may not know the actual risk each of your patients face due to their health and life style choices.

         With the Team Chart Concept from Ulrich Medical Concepts , you can calculate and track the risk of coronary heart disease based on the Framingham 10-Year Risk Calculator. The risk factors included in the Framingham Calculation are: 

• Age
• Sex
• Cholesterol
• Blood Pressure
• Smoking Habits

        The risk to a patient can be instantly calculated while seeing the patient in the exam room.  For example, the following record displays the risk to a hypothetical patient, John Doe:

Doe, John K (male, age 41, Blood Pressure 140/90)

06-28-2002 Fri 04:49:00 PM

CARDIAC RISK - Framingham 10-Year Risk

Smoking Habits: Y

TRG: 168

TCh: 210

HDL: 42

LDL: 135

VLDL: 34

TC/HDL=: 5

Age frf: 0

BPT frf: 2

HDL frf: 1

TCH frf: 5

Smk frf: 5

TOT frf: 13

FRS % 10 yr risk: 12

HDL Goal: Increase HDL to 45

LDL goal: Moderate CV event Risk LDL goal < 130

         The above Cardiac Risk Entry for our hypothetical patient, John Doe, has calculated a 12% risk of coronary disease over the next 10 years. (Note that the 1st six fields, Smoking Habits, TRG, TCh, HDL, LDL, VLDL, are entered by the user, or automatically imported from Lab Results. The remaining fields are computed fields.)

         You can show this Cardiac Risk Assessment to the patient. Then you can show the patient how much his risk will drop if he quits smoking (by simply changing the 'Smoking Habits' Field from a Yes to a No):

Doe, John (male, age 41)

06-28-2002 Fri 04:49:00 PM

CARDIAC RISK - Framingham 10-Year Risk

Smoking Habits: N

TRG: 168

TCh: 210

   . . .

Smk frf: 0

TOT frf: 8

FRS % 10 yr risk: 4

HDL Goal: Increase HDL to 45

LDL goal: Moderate CV event

        In this case, if John Doe stops smoking his risk drops from 12% to 4%. You could also demonstrate the effects of lowering his cholesterol.

        As you can see, the physician now has an extremely powerful, and easy-to-use motivational tool to encourage patients to make life-style changes.

        We can take this motivational tool one step further and inform Mr. John Doe as to how his risk has been progressing over time.  Consider the following report (which can be run in a matter of seconds during the patient exam):

Ulrich Medical Concepts - Framingham Risk,

For: Doe, John M (01-01-2002 to 06-28-2002)

Report Run On 06-28-2002 Fri 05:51:46 PM

Date       BP Diast. TCh TC/HDL TOT frf Smokes 10 yr risk

2002-01-02 95        210 5      13      Y      12   

2002-02-04 90        197 5.63   12      Y      10   

2002-03-05 90        189 5.11   11      Y      8   

2002-04-17 80        183 4.69   11      Y      8   

2002-06-07 85        163 3.4    4       N      1   

 

        Notice that in this example the last column (10 yr risk) has been moving steadily downward.  To better show the progress, you can graph the Framingham Risk Report as shown here:

        Again, Risk Factor Analysis routines can be run during the patient exam for quick and easy use in planning treatment for your patients.  You can even auto-paste the output from the Risk Factor Routines and the Reports into the dictation for the patient encounter (and receive Medicare Audit Points for doing so).

        This is better patient care.

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