The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study.
The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study.
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DOI：
10.2196/31186
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发表时间：
2021-11-12
影响因子：
3.2
通讯作者：
Yazdany J
中科院分区：
文献类型：
--
作者：
Hammam N;Izadi Z;Li J;Evans M;Kay J;Shiboski S;Schmajuk G;Yazdany J
类风湿性关节炎(RA)的疾病活动性(DA)和患者报告结果(PRO)的常规收集是国家认可的质量衡量标准，也是治疗目标方法的关键组成部分。然而，人们对电子健康记录(EHR)系统在促进这些措施的执行方面所起的作用知之甚少。利用美国大学风湿病学会(ACR‘s)的RISE注册表，我们分析了EHR系统与DA和功能状态(FS)质量测量的关系。我们分析了2018年从Rise注册的实践中收集的数据。我们评估了需要DA和FS文档的质量措施的实践级绩效。使用多元线性回归和零膨胀负二项模型检验EHR系统对实习水平质量测量绩效的独立影响，并根据实习特点和患者病例组合进行调整。总共有220名患者接受了314,793名RA患者的治疗。NextGen是最常用的电子病历系统(34.1%)。我们发现，EHR系统在DA和FS质量指标上的表现差异很大(中位数分别为30.1，IQR 0-74.8和中位数9.0，IQR 0-74.2)。即使在调整后，NextGen Practice在DA指标上的表现也明显好于AllSCRIPTS(51.4%比5.0%；P<；0.05)，在FS指标上显著好于eClinicalWorks和EMDS(49.3%比29.0%和10.9%；P<；0.05)。国家RA质量措施的绩效与EHR系统相关，即使在根据实践和患者特征进行调整后也是如此。这些发现表明，未来改善RA护理质量的努力不仅应该集中在提供者的表现报告上，还应该集中在制定和实施整个EHR的风湿病专用标准上。
Routine collection of disease activity (DA) and patient-reported outcomes (PROs) in rheumatoid arthritis (RA) are nationally endorsed quality measures and critical components of a treat-to-target approach. However, little is known about the role electronic health record (EHR) systems play in facilitating performance on these measures. Using the American College Rheumatology’s (ACR’s) RISE registry, we analyzed the relationship between EHR system and performance on DA and functional status (FS) quality measures. We analyzed data collected in 2018 from practices enrolled in RISE. We assessed practice-level performance on quality measures that require DA and FS documentation. Multivariable linear regression and zero-inflated negative binomial models were used to examine the independent effect of EHR system on practice-level quality measure performance, adjusting for practice characteristics and patient case-mix. In total, 220 included practices cared for 314,793 patients with RA. NextGen was the most commonly used EHR system (34.1%). We found wide variation in performance on DA and FS quality measures by EHR system (median 30.1, IQR 0-74.8, and median 9.0, IQR 0-74.2), respectively). Even after adjustment, NextGen practices performed significantly better than Allscripts on the DA measure (51.4% vs 5.0%; P<.05) and significantly better than eClinicalWorks and eMDs on the FS measure (49.3% vs 29.0% and 10.9%; P<.05). Performance on national RA quality measures was associated with the EHR system, even after adjusting for practice and patient characteristics. These findings suggest that future efforts to improve quality of care in RA should focus not only on provider performance reporting but also on developing and implementing rheumatology-specific standards across EHRs.
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影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
DOI：
10.1002/art.24345
发表时间：
2009-04-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Collier, Deborah S.;Kay, Jonathan;Grant, Richard W.
通讯作者：
Grant, Richard W.
影响因子：
4.7
作者：
Newman, Eric D.;Lerch, Virginia;Kirchner, H. Lester
通讯作者：
Kirchner, H. Lester
影响因子：
4.7
作者：
Yazdany, Jinoos;Bansback, Nick;Kazi, Salahuddin
通讯作者：
Kazi, Salahuddin
影响因子：
120.7
作者：
Schmajuk, Gabriela;Trivedi, Amal N.;Yazdany, Jinoos
通讯作者：
Yazdany, Jinoos