J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring.

Tópicos

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Resumo

CKGROUND: 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.

Resumo Limpo

ckground sinc new york citi primari care inform project assist provid adopt use preventionori electron health record ehr particip practic taught readjust workflow use ehr builtin popul health monitor tool includ autom qualiti measur patient registri clinic decis support system practic receiv comprehens suit technic assist includ qualiti improv ehr custom configur privaci secur train revenu cycl optim servic aim help provid understand use ehr track improv qualiti care deliv patientsmateri method retrospect electron chart review patient record across practic analyz determin valid ehrderiv qualiti measur document prevent servicesresult result studi show workflow document habit profound impact ehrderiv qualiti measur compar manual review electron chart ehrderiv measur can undercount practic perform disproportion negat impact number patient captur receiv clinic prevent servic meet recommend treatment goalconclus studi provid cautionari note use ehrderiv measur public report provid perform use payment

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