title: Method for developing national quality indicators based on manual data extraction from medical records.
abstract: Developing quality indicators (QI) for national purposes (eg, public disclosure, paying-for-performance) highlights the need to find accessible and reliable data sources for collecting standardised data. The most accurate and reliable data source for collecting clinical and organisational information still remains the medical record. Data collection from electronic medical records (EMR) would be far less burdensome than from paper medical records (PMR). However, the development of EMRs is costly and has suffered from low rates of adoption and barriers of usability even in developed countries. Currently, methods for producing national QIs based on the medical record rely on manual extraction from PMRs. We propose and illustrate such a method. These QIs display feasibility, reliability and discriminative power, and can be used to compare hospitals. They have been implemented nationwide in France since 2006. The method used to develop these QIs could be adapted for use in large-scale programmes of hospital regulation in other, including developing, countries.
authors.affiliation: INSERM U988, Institut Gustave Roussy, 38 rue Camille Desmoulins, Villejuif Cedex, France.
authors.forename: Melanie
authors.initials: M
authors.lastname: Couralet
authors.forename: Henri
authors.initials: H
authors.lastname: Leleu
authors.forename: Frederic
authors.initials: F
authors.lastname: Capuano
authors.forename: Leah
authors.initials: L
authors.lastname: Marcotte
authors.forename: Gérard
authors.initials: G
authors.lastname: Nitenberg
authors.forename: Claude
authors.initials: C
authors.lastname: Sicotte
authors.forename: Etienne
authors.initials: E
authors.lastname: Minvielle
mesh_terms: D054869:Clinical Audit / Q000379:methods; D004059:Diffusion of Innovation; D016002:Discriminant Analysis; D005240:Feasibility Studies; D005602:France; D006761:Hospitals / Q000145:classification*; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D010865:Pilot Projects; D058996:Quality Improvement; D019984:Quality Indicators, Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012494:Sampling Studies