The challenge of measuring quality of care from the electronic health record.
The electronic health record (EHR) is seen by many as an ideal vehicle for measuring quality of health care and monitoring ongoing provider performance. It is anticipated that the availability of EHR-extracted data will allow quality assessment without the expensive and time-consuming process of medical record abstraction. A review of the data requirements for the indicators in the Quality Assessment Tools system suggests that only about a third of the indicators would be readily accessible from EHR data. Other factors involving complexity of required data elements, provider documentation habits, and EHR variability make the task of quality measurement more difficult than may be appreciated. Accurately identifying eligible cases for quality assessment and validly scoring those cases with EHR-extracted data will pose significant challenges but could potentially plummet the cost and therefore expand the use of quality assessment.
Roth
Carol P
CP
RAND Health, Santa Monica, California 90407-2138, USA. roth@rand.org
Lim
Yee-Wei
YW
Pevnick
Joshua M
JM
Asch
Steven M
SM
McGlynn
Elizabeth A
EA
D054869:Clinical Audit / Q000592:standards; D016347:Medical Records Systems, Computerized / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*