Validity of electronic health record-derived quality measurement for performance monitoring.
Validity of electronic health record-derived quality measurement for performance monitoring.
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DOI：
10.1136/amiajnl-2011-000557
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发表时间：
2012-07
期刊：
影响因子：
--
通讯作者：
Shih S
中科院分区：
文献类型：
--
作者：
Parsons A;McCullough C;Wang J;Shih S
自2007年以来，纽约市的初级保健信息项目已协助3000多名提供者采用和使用以预防为导向的电子健康记录（EHR）。参与实践被教导重新调整他们的工作流程，以使用EHR内置的人口健康监测工具，包括自动化质量测量，患者登记和临床决策支持系统。Practices获得了一套全面的技术援助，其中包括质量改进、电子健康记录定制和配置、隐私和安全培训以及收入周期优化。这些服务旨在帮助提供者了解如何使用EHR来跟踪和提高为患者提供的护理质量。回顾性电子病历审查4081例患者的记录在57个做法进行了分析，以确定EHR派生的质量措施和记录的预防服务的有效性。从这项研究的结果表明，工作流程和文档的习惯有着深远的影响，EHR派生的质量措施。与人工审查电子病历相比，EHR衍生的措施可能会低估实践绩效，对接受临床预防服务或达到推荐治疗目标的患者数量产生不成比例的负面影响。这项研究提供了一个警示说明，在使用EHR衍生的测量提供商的业绩或使用支付的公开报告。
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. 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 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. This study provides a cautionary note in using EHR-derived measurement for public reporting of provider performance or use for payment.
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影响因子：
39.2
作者：
JOLLIS, JG;ANCUKIEWICZ, M;MARK, DB
通讯作者：
MARK, DB
DOI：
10.1136/jamia.2009.002451
发表时间：
2010-03-01
影响因子：
6.4
作者：
Kahn, Michael G.;Banade, Dalksha
通讯作者：
Banade, Dalksha
影响因子：
9.7
作者：
Roski, Joachim;McClellan, Mark
通讯作者：
McClellan, Mark
DOI：
10.1177/1077558709359007
发表时间：
2010-10-01
期刊：
Medical care research and review : MCRR
影响因子：
--
作者：
Chan, Kitty S;Fowles, Jinnet B;Weiner, Jonathan P
通讯作者：
Weiner, Jonathan P
DOI：
10.1016/j.ijmedinf.2008.05.005
发表时间：
2010-05-01
影响因子：
4.9
作者：
Galanter, William L.;Hier, Daniel B.;Sarne, David
通讯作者：
Sarne, David