Related Experiment Video
Updated: Jun 9, 2026
06:05
The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
The comprehensive care project: measuring physician performance in ambulatory practice.
Eric S Holmboe1, Weifeng Weng, Gerald K Arnold
1American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106, USA. eholmboe@abim.org
Health Services Research
|September 8, 2010
Summary
Comprehensive physician performance assessment in ambulatory care is feasible, reliable, and valid. Composite measures for chronic and preventive care, using feasible patient sampling, can effectively evaluate physician quality.
Area of Science:
- Healthcare Quality
- Medical Performance Measurement
- Ambulatory Care
Background:
- Assessing physician performance in ambulatory settings is crucial for quality improvement.
- Existing methods may not comprehensively capture physician-level quality across various care domains.
Purpose of the Study:
- To evaluate the feasibility, reliability, and validity of a comprehensive physician performance assessment system.
- To determine the extent of within- and between-physician variation in performance.
- To assess the external validity of the performance measures.
Main Methods:
- Conducted a study involving general internists from 13 states.
- Audited medical records for chronic, acute, and preventive care services for 236 physicians.
- Quantified performance variation using intraclass correlation coefficients (ICC) and correlated with certification exam scores.
Main Results:
- Substantial variation in performance was observed both within and between physicians.
- Composite measures demonstrated robust reliability (0.88 for chronic care, 0.87 for preventive care).
- Higher certification exam scores correlated with better overall, chronic care, and preventive care performance.
Conclusions:
- Comprehensive assessment of physician performance in ambulatory care is achievable.
- Composite measures and feasible patient sampling enhance the reliability and validity of quality assessments.
- This approach supports effective evaluation of chronic and preventive care quality.
Related Concept Videos
01:26Methods of Documentation II: POMR
The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:13Patient-centered Care
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...