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Study Highlights Potential to Refine Quality of Care Measures for EHRs

A federally funded study conducted by Weill Cornell Medical College and appearing in the Annals of Internal Medicine illustrates ways in which quality measurements from electronic health records (EHRs) can be improved. A Weill Cornell news release reports that $27 billion in federal financial incentives was recently offered to health care providers and hospitals to use EHRs in ways that demonstrably improve the quality of care. The incentives, researchers say, are based in part on the ability to electronically report clinical quality measures.

During the New York-based cross-sectional study, Weill Cornell researchers say that they analyzed clinical data from the EHRs of one of the largest community health center networks in New York State. The team’s focus centered on the accuracy of electronic reporting for 12 quality measures, 11 of which researchers say are included in the federal government’s set of measurements for incentives. The results indicate a fair consistency for nine measures, but not for the remaining three.

Lisa Kern, MD, MPH, lead investigator, general internist, associate director for research at the Center for Healthcare Informatics at Weill Cornell, notes that the “variation in quality measurement that we found in a leading electronic health record systems speaks to the need to test and iteratively refine traditional quality measures so that they are suited to the documentation patterns in EHRs.”

Study results also indicate that automated reports generally performed well, yet the reports underestimated the percentage of patients receiving prescriptions for asthma and receiving vaccinations to protect from bacterial pneumonia. A third measure suggested that more patients with diabetes had cholesterol under control than actually did. The automated report said 57% of eligible diabetic patients had cholesterol controlled, while a manual check of the charts showed it was actually 37%. A key component of the issue, researchers say, may stem from physicians and nurses filling out the EHRs and typing in information in a place that is not being captured by quality reporting algorithms.

“EHRs are not just electronic versions of paper records but rather tools that enable transformation in the way care is delivered, documented, measured, and improved. The federal meaningful use program will enable the deployment of these promising systems across the country, thereby enabling health care to enter the digital age,” explains Rainu Kaushal, MD, MPH, director of the Center for Healthcare Informatics Policy, chief of the division of Quality and Medical Informatics, Frances and John L. Loeb Professor of Medical Informatics, Weill Cornell.

The release notes that the study was funded by the federal Agency for Healthcare Research and Quality and showcased in an AHRQ video. Click here to watch it now.

[Source: Weill Cornell]