title: Elderly Surgical Patients: Automated Computation of Healthcare Quality Indicators by Data Reuse of EHR.
abstract: The objective of the work is to implement and evaluate the automated computation of 9 healthcare quality indicators, by data reuse of electronic health records, in the field of elderly surgical patients.
  
  
  METHODS
  Data are extracted from EHR, including administrative data, ICD10 diagnoses, laboratory results, procedures, administered drugs, and free-text letters. The indicators are implemented by a medical data reuse specialist. The conformity rate is automatically computed (3.5 minutes for 15,000 inpatient stays and 9 indicators). A medical expert reviews 45 stays per indicator. The precision is the proportion of non-conform inpatient stays among the cases detected as non-conform by the algorithms.
  
  
  RESULTS
  the paper describes the implemented algorithms, the conformity rates and the precisions. Two indicators have a precision of 0%, 3 indicators have a precision of 40 to 60%, and four indicators have a precision from 80 to 100% (for 2 of them, the conformity rate is lower than 2.5%!). This demonstrates that automated quality screening is possible and enables to detect threatening situations. The implementation of the indicators requires special skills in medicine, medical information sciences, and algorithmics. Failures of precision are mainly due to defaults of information quality (missing codes), and could benefit from text analysis.
authors.affiliation: Univ. Lille, EA 2694 Public Health, F-59000 Lille, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Ficheur
authors.affiliation: Department of Medical Information, St Philibert Hospital, GHICL, Lille, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Schaffar
authors.affiliation: CHU Lille, Public health department, F-59000 Lille, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Caron
authors.affiliation: CHU Lille, Public health department, F-59000 Lille, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Balcaen
authors.affiliation: Univ. Lille, EA 2694 Public Health, F-59000 Lille, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Beuscart
authors.affiliation: Univ. Lille, EA 2694 Public Health, F-59000 Lille, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chazard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D066289:Data Curation / Q000379:methods / Q000592:standards; D057286:Electronic Health Records / Q000145:classification / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005602:France; D013502:General Surgery / Q000592:standards / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009323:Natural Language Processing; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000592:standards* / Q000706:statistics & numerical data*