Improving the quality of EHR recording in primary care: a data quality feedback tool.
Electronic health record (EHR) data are used to exchange information among health care providers. For this purpose, the quality of the data is essential. We developed a data quality feedback tool that evaluates differences in EHR data quality among practices and software packages as part of a larger intervention.



The tool was applied in 92 practices in the Netherlands using different software packages. Practices received data quality feedback in 2010 and 2012.



We observed large differences in the quality of recording. For example, the percentage of episodes of care that had a meaningful diagnostic code ranged from 30% to 100%. Differences were highly related to the software package. A year after the first measurement, the quality of recording had improved significantly and differences decreased, with 67% of the physicians indicating that they had actively changed their recording habits based on the results of the first measurement. About 80% found the feedback helpful in pinpointing recording problems. One of the software vendors made changes in functionality as a result of the feedback.



Our EHR data quality feedback tool is capable of highlighting differences among practices and software packages. As such, it also stimulates improvements. As substantial variability in recording is related to the software package, our study strengthens the evidence that data quality can be improved substantially by standardizing the functionalities of EHR software packages.
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands R.verheij@nivel.nl.
Sjoukje
S
van der Bij
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Nasra
N
Khan
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Petra
P
Ten Veen
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.|Tilburg University, Scientific Centre for Transformation in Care and Welfare (TRANZO), Tilburg, The Netherlands.
Dinny H
DH
de Bakker
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Robert A
RA
Verheij
D059019:Clinical Coding / Q000592:standards*; D000068598:Data Accuracy; D057286:Electronic Health Records / Q000592:standards*; D005246:Feedback; D006801:Humans; D016347:Medical Records Systems, Computerized; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011787:Quality of Health Care; D012984:Software
electronic health record; medical informatics; primary care