Pursuing integration of performance measures into electronic medical records: beta-adrenergic receptor antagonist medications
| Autor: | Clement J. McDonald, John N. Lewis, Michael Weiner, Christopher M. Callahan, Timothy E. Stump |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Indiana
Medical Records Systems Computerized Leadership and Management Cross-sectional study Adrenergic beta-Antagonists Myocardial Infarction Medicare Drug Utilization Review Hospitals Urban Chart Humans Medicine Performance measurement Myocardial infarction General Nursing Aged Quality Indicators Health Care Academic Medical Centers Medical Audit business.industry Health Policy Medical record Public Health Environmental and Occupational Health Electronic medical record medicine.disease Systems Integration Cross-Sectional Studies Original Article Performance indicator Medical emergency business |
| Zdroj: | Quality and Safety in Health Care. 14:99-106 |
| ISSN: | 1475-3901 1475-3898 |
| Popis: | Objective: Electronic medical records seldom integrate performance indicators into daily operations. Assessing quality indicators traditionally requires resource intensive chart reviews of small samples. We sought to use an electronic medical record to assess use of s-adrenergic antagonist medications (s-blockers) following myocardial infarction, to compare a standardized manual assessment with assessment using electronic medical records, and to discuss potential for future integration of performance indicators into electronic records. Design: Cross-sectional data analysis. Setting: An urban academic medical center. Participants: US Medicare beneficiaries 65 years of age or older, admitted to hospital with myocardial infarction between 1995 and 1999. Measurements and main results: Manual chart review was compared with a computer driven assessment of electronic records. Administration of s-blockers and cases excluded from use of s-blockers were measured, based on Medicare criteria. Among 4490 older adults, 391 (4%) of 9018 hospital admissions contained codes for myocardial infarction. In 323 (83%) of the 391 hospital admissions, criteria for excluding s-blockers were met; 235 (60%) were excluded due to heart failure. Of 68 hospital admissions for myocardial infarction that did not meet exclusion criteria, physicians prescribed s-blockers in 49 (72%) on admission and 42 (62%) at discharge. Compared with manual chart review, electronic review had a sensitivity of 83–100% and led to fewer false negative findings. Conclusions: An electronic medical records system can be used instead of chart review to measure use of s-blockers after myocardial infarction. This should lead to integration of real time automated performance measurement into electronic medical records. |
| Databáze: | OpenAIRE |
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