Study: EHRs valuable in identifying quality care
Diabetic patients sampled
A study in the January/February issue of the Journal of the American Medical Informatics Association1 quantifies the difference between calculating quality measures for diabetes using claims data and data extracted from an electronic health record (EHR). The study was conducted by the Palo Alto Medical Foundation and Lumetra, California's QIO, as part of the Doctor's Office Quality project.
The researchers, led by Paul Tang, MD, MS, took a random sample of medical charts from Medicare beneficiaries with diabetes. Then, based on the sample of 125 charts, they identified diabetics two ways using the same predefined inclusion criteria — by administrative claims data and by coded clinical data in an EHR.
Only 75% of Medicare beneficiaries with diabetes were identified using administrative data, while coded information in the EHR revealed 97% of the diabetics with a specificity of 99.6%. Differences in the detection of quality measures for HbA1c testing, blood pressure, urine testing, and eye exams also were found to be statistically significant.
"New development of standardized quality measures should shift from claims-based measures to clinically based measures that can be derived from coded information in an EHR," conclude the authors. "Without adding burden to the care process, clinical data entered by clinicians into an EHR system at the point of care should be mined to generate new knowledge, measure performance, and reward those who deliver the best care with the best outcomes."2
References
- Tang PC, Ralston M, Arrigotti MF, Qureshi L and Graham J. Comparison of methodologies for calculating quality measures based on administrative data versus clinical data from an electronic health record system: Implications for performance measures.J Am Med Inform Assoc. 2007;14:10-15.
- Ibid.
For additional information, contact:
Paul C. Tang, MD, Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301. Phone: (650) 853-5775. Fax: (650) 853-6050. E-mail: [email protected].
A study in the January/February issue of the Journal of the American Medical Informatics Association1 quantifies the difference between calculating quality measures for diabetes using claims data and data extracted from an electronic health record (EHR).You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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