Perspect Health Inf Manag - Identifying patients with hypertension: a case for auditing electronic health record data.

Tópicos

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Resumo

Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

Resumo Limpo

problem structur consist complet electron health record data barrier outcom research qualiti improv practic redesign nonexperiment retrospect studi examin util import deidentifi electron health record data extern system identifi patient risk essenti hypertens find statist signific increas case base combin use diagnost freetext code mean ci compar diagnost code alon mean ci surpris signific patient identifi broaden search criteria implic critic qualiti care movement toward nation committe qualiti assur patientcent medic home program meaning use electron health record find statist signific increas potenti case base last two blood pressur read greater equal mm hg mean ci

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