Validity of electronic health record-derived quality measurement for performance monitoring

Autor: Amanda Parsons, Colleen M. McCullough, Sarah Shih, Jason J. Wang
Rok vydání: 2012
Předmět:
Male
Quality management
Quality Assurance
Health Care
health care facilities
manpower
and services
Information Storage and Retrieval
primary care information project
Workflow
0302 clinical medicine
Documentation
PCIP)
Electronic Health Records
Medicine
030212 general & internal medicine
health care economics and organizations
media_common
Medical Audit
030503 health policy & services
Middle Aged
3. Good health
EHR-derived quality measures
Benchmarking
Female
Medical emergency
0305 other medical science
Adult
media_common.quotation_subject
Health Informatics
Population health
Research and Applications
Clinical decision support system
primary care
03 medical and health sciences
Nursing
health services administration
electronic medical records
Humans
Revenue
Quality (business)
extension center
Reimbursement
Incentive
Retrospective Studies
Primary Health Care
business.industry
meaningful use measures
Reproducibility of Results
Payment
medicine.disease
ComputingMilieux_COMPUTERSANDSOCIETY
New York City
business
Zdroj: Journal of the American Medical Informatics Association : JAMIA
ISSN: 1527-974X
1067-5027
Popis: Background Since 2007, New York City's primary care information project has assisted over 3000 providers to adopt and use a prevention-oriented electronic health record (EHR). Participating practices were taught to re-adjust their workflows to use the EHR built-in population health monitoring tools, including automated quality measures, patient registries and a clinical decision support system. Practices received a comprehensive suite of technical assistance, which included quality improvement, EHR customization and configuration, privacy and security training, and revenue cycle optimization. These services were aimed at helping providers understand how to use their EHR to track and improve the quality of care delivered to patients. Materials and Methods Retrospective electronic chart reviews of 4081 patient records across 57 practices were analyzed to determine the validity of EHR-derived quality measures and documented preventive services. Results Results from this study show that workflow and documentation habits have a profound impact on EHR-derived quality measures. Compared with the manual review of electronic charts, EHR-derived measures can undercount practice performance, with a disproportionately negative impact on the number of patients captured as receiving a clinical preventive service or meeting a recommended treatment goal. Conclusion This study provides a cautionary note in using EHR-derived measurement for public reporting of provider performance or use for payment.
Databáze: OpenAIRE
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