Performance Measures Using Electronic Health Records: Five Case Studies

Publication Date: April 2008

Publisher: Robert Wood Johnson Foundation; The Commonwealth Fund

Author(s): K.S. Chan; J.P. Weiner; J.B. Fowles

Research Area: Health

Type: Report

Abstract:

The use of electronic health records and information is expanding rapidly. This article describes five case studies that illustrate both the benefits and challenges for providers in implementing new quality of care measures associated with the use of electronic data.

The development of electronic health records (EHRs) or electronic medical records, such as computerized physician order entry, clinical decision support systems and Web-based patient portals, has made it possible and necessary to design a new set of quality-of-care indicators that work with these systems. This report, developed with support from the Robert Wood Johnson Foundation and the Commonwealth Fund, examines the experiences of five provider organizations in creating, testing and implementing such e-indicators based on data that they collected from the EHR systems. Each case study highlights the variety, strengths and potential challenges of initiating quality-of-care measures associated with EHR data. The studies illustrate the potential of EHR to:

* Compute traditional quality measures (in this case, for blood pressure control) aimed at eliminating the cost of pulling the data manually.
* Assemble composite measures (in this case, for diabetes) that would be feasible using traditional measures.
* Coordinate care and manage potential drug interactions (in this case, creating a warfarin and antibiotic alert).
* Capture unstructured information and use it for quantitative analysis.

Although the particulars of each case study are different, all of the scenarios presented demonstrate success in implementing EHR-based quality measures, despite the challenges of ensuring reliability and validity of the data.