Validity of electronic health record-derived quality measurement for performance monitoring

Amanda Parsons, Colleen McCullough, Jason Wang, Sarah Shih

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

Background 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 readjust 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.

Original languageEnglish (US)
Pages (from-to)604-609
Number of pages6
JournalJournal of the American Medical Informatics Association
Volume19
Issue number4
DOIs
Publication statusPublished - Jul 1 2012
Externally publishedYes

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ASJC Scopus subject areas

  • Health Informatics

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