Quality of lipid management in outpatient care: a national study using electronic health records

To examine lipid management in a large national outpatient network, a cross-sectional study was conducted that included 1,385,242 active patients ages 20 to 79 years of age in a national network of over 5000 providers using electronic health records (EHRs). Adequate lipid testing, achievement of lipid goals, and appropriate use of lipid-lowering medication were defined according to National Cholesterol Education Program (NCEP) guidelines. Lipid testing was adequate for 62% of high-risk, 67% of moderate-risk, and 36% of low-risk patients. Lipid goals were achieved in 65%, 66%, and 90% of these 3 risk groups; 35%, 45%, and 32% achieved adequate testing and optimal goals. Medications were appropriately prescribed for 70%, 47%, and 48%. There is significant room for improvement in lipid management, particularly among high-risk patients. National EHR networks are excellent vehicles for large outpatient quality of care studies, particularly for measuring clinical outcomes such as lipid levels.