Development of Risk-Adjusted Outcome Measures in the EHR Environment

EHR 环境中风险调整结果措施的制定

• 批准号: 8259360
• 负责人: Stephen Schmaltz
• 金额: $ 4.97万
• 依托单位: JOINT COMMISSION
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2012-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8259360
• 关键词: Development; Risk; Adjusted; Outcome; Measures

DESCRIPTION (provided by applicant): We are proposing to hold an invitational conference to examine issues related to the identification and development of outcome measures, and their accompanying risk adjustment models, in the electronic health record (EHR) environment. This conference will address methodological issues that will form the basis for a demonstration project to develop risk- adjusted outcome measures generated from the EHR. These risk-adjusted outcome measures would be useful for oversight, internal quality improvement, public reporting, pay-for- performance and consumer decision-making. Outcome measures assess the results of the patient's health care system encounter, and they are particularly useful for evaluating the quality of that care. Due to difficulties in locating and collecting accurate and comprehensive data on health outcomes, performance measurement efforts have primarily focused on the processes of care. Yet, in most areas, the relationship between the processes of care being measured and specific health outcomes has yet to be established. The introduction of the EHR across the broad spectrum of health care is expected to provide new opportunities to access and gather data upon which outcome measures can be based. In order to accurately compare performance across providers and over time outcome measures require risk adjustment. The quality and usefulness of an outcome measure depends on the quality of the risk adjustment model accompanying it. Widespread EHR implementation holds the promise of supplying more and better data upon which to construct these models. The following questions will be explored at the conference. (1) How can EHR data be used to develop risk models for existing mortality and readmission outcome measures? (2) What EHR data originating from outside the hospital walls will be useful for the development of risk adjusted outcome measures in the hospital setting, and in settings outside of the hospital? (3) What new risk adjusted outcome measures (beyond mortality and readmission rates) can be generated through the use of EHR data? (4) What are the challenges and barriers to the development of risk adjusted outcome measures in the EHR environment, and how can these barriers be overcome? Information generated by the conference will form the basis of a demonstration project during which risk adjusted outcome measures useful for monitoring and improving health care quality will be developed and tested using EHR data. PUBLIC HEALTH RELEVANCE: This conference will address methodological issues that will form the basis for a demonstration project to develop risk-adjusted outcome measures generated from the EHR. It will pave the way for a significant increase in the number of risk-adjusted outcome measures available for oversight, internal quality improvement, public reporting, pay-for-performance and consumer decision-making, across a wider variety of health care settings.

描述（由申请人提供）： 我们建议举行一次邀请会议，以研究与电子健康记录（EHR）环境中的结果测量及其伴随的风险调整模型的识别和开发相关的问题。这次会议将解决方法问题，这将构成一个示范项目的基础，以开发从电子健康记录产生的风险调整的结果措施。这些经风险调整的成果措施将有助于监督、内部质量改进、公开报告、按业绩计薪和消费者决策。 结果的措施评估病人的医疗保健系统遇到的结果，他们是特别有用的，以评估该护理的质量。由于难以定位和收集准确而全面的健康结果数据，绩效衡量工作主要集中在护理过程上。然而，在大多数地区，所衡量的护理过程与具体的健康结果之间的关系尚未确定。在广泛的医疗保健领域引入电子健康记录，预计将为访问和收集结果测量所依据的数据提供新的机会。 为了准确地比较各提供者的业绩，随着时间的推移，结果措施需要进行风险调整。结果度量的质量和有用性取决于伴随它的风险调整模型的质量。广泛的EHR实施有望提供更多更好的数据来构建这些模型。 会议将探讨以下问题。(1)如何使用EHR数据为现有的死亡率和再入院结局指标开发风险模型？(2)什么样的EHR数据来源于医院之外，将有助于在医院环境和医院之外的环境中制定风险调整的结局指标？(3)通过使用EHR数据，可以产生哪些新的风险调整结局指标（除了死亡率和再入院率）？(4)在EHR环境中开发风险调整结果指标面临哪些挑战和障碍，以及如何克服这些障碍？ 会议产生的信息将构成一个示范项目的基础，在此期间，将使用EHR数据开发和测试用于监测和提高医疗质量的风险调整结果措施。 公共卫生关系：本次会议将讨论方法问题，这些问题将构成一个示范项目的基础，以制定从EHR产生的风险调整结果措施。它将为在更广泛的卫生保健环境中大幅增加可用于监督、内部质量改进、公共报告、按业绩付费和消费者决策的风险调整结果措施铺平道路。