WIP 136 - Analyzing the Use of Standardized Order Guidelines in the Treatment of Ambulatory Lyme Disease

Poster Number: WIP 136
Publication Number: WIP 136.896

Background: Lyme disease in Ohio and surrounding states has increased rapidly in the past decade and many providers in the community seem unfamiliar with the current best practices. At Akron Children’s Hospital (ACH), Lyme disease cases have gone up by 190% in the past 5 years with a large number of patients being managed in the outpatient setting. This explosion of Lyme cases created a need for standardization of diagnosis and management. Review of our baseline data showed inconsistencies in both diagnostic testing and treatment of Lyme patients. Infectious Disease Society of America (IDSA) guidelines for prevention, diagnosis and management of Lyme disease were published in 2020; we wanted to utilize electronic medical record-based tools to align our management with these IDSA guidelines.

Objective: This study seeks to measure the impact of an order set on standardizing management of Lyme Disease in the ambulatory setting.

Design/Methods: Background data regarding rates of Lyme disease in patients seen through ACH were collected using the SlicerDicer© tool on Epic electronic medical record system (EMR). The antibiotic stewardship team at ACH developed a standardized smart set on Epic EMR which was made available to all general pediatric providers in the health system. This smart set guides appropriate testing and auto selects drug dosing and duration depending on the patients age, weight and stage of Lyme disease. Baseline data was collected from 2015 to 2021 and included the number of Lyme patients diagnosed, antibiotics prescribed, and testing performed. The guideline went live in May 2022; data collection continues post guideline implementation. We plan to analyze the impact of the guideline on Lyme management and concordance with national recommendation in the ACH health care system.