Comparison of GE Centricity Electronic Medical Record database and National Ambulatory Medical Care Survey findings on the prevalence of major conditions in the United States.
The study objective was to facilitate investigations by assessing the external validity and generalizability of the Centricity Electronic Medical Record (EMR) database and analytical results to the US population using the National Ambulatory Medical Care Survey (NAMCS) data and results as an appropriate validation resource. Demographic and diagnostic data from the NAMCS were compared to similar data from the Centricity EMR database, and the impact of the different methods of data collection was analyzed. Compared to NAMCS survey data on visits, Centricity EMR data shows higher proportions of visits by younger patients and by females. Other comparisons suggest more acute visits in Centricity and more chronic visits in NAMCS. The key finding from the Centricity EMR is more visits for the 13 chronic conditions highlighted in the NAMCS survey, with virtually all comparisons showing higher proportions in Centricity. Although data and results from Centricity and NAMCS are not perfectly comparable, once techniques are employed to deal with limitations, Centricity data appear more sensitive in capturing diagnoses, especially chronic diagnoses. Likely explanations include differences in data collection using the EMR versus the survey, particularly more comprehensive medical documentation requirements for the Centricity EMR and its inclusion of laboratory results and medication data collected over time, compared to the survey, which focused on the primary reason for that visit. It is likely that Centricity data reflect medical problems more accurately and provide a more accurate estimate of the distribution of diagnoses in ambulatory visits in the United States. Further research should address potential methodological approaches to maximize the validity and utility of EMR databases.
Crawford
Albert G
AG
Thomas Jefferson University School of Population Health, Philadelphia, Pennsylvania, USA.
Cote
Christine
C
Couto
Joseph
J
Daskiran
Mehmet
M
Gunnarsson
Candace
C
Haas
Kara
K
Haas
Sara
S
Nigam
Somesh C
SC
Schuette
Rob
R
Yaskin
Joseph
J
D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015982:Bias; D002908:Chronic Disease / Q000453:epidemiology; D003625:Data Collection / Q000379:methods / Q000592:standards; D016208:Databases, Factual / Q000592:standards*; D004282:Documentation; D057286:Electronic Health Records; D005260:Female; D019538:Health Care Surveys / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D015995:Prevalence; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology