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Making audit actionable: an example algorithm for blood pressure management in chronic kidney disease.
Benjamin Brown1, Richard Williams1, Matthew Sperrin1
1Centre for Health Informatics, University of Manchester, UK ; Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester, UK.
Summary
An algorithm analyzing electronic health records (EHR) identified significant opportunities to improve blood pressure (BP) management in chronic kidney disease (CKD) patients, linking audit data to actionable care improvements.
Area of Science:
- Health Informatics
- Nephrology
- Clinical Audit
Background:
- Clinical guidelines are not always followed in practice.
- Electronic health records (EHR) offer data for care improvement but lack actionable detail.
- Improving blood pressure (BP) management in chronic kidney disease (CKD) is crucial.
Purpose of the Study:
- To develop an algorithm for actionable insights into care quality improvement.
- To use BP management in CKD as an exemplar for the algorithm's application.
Main Methods:
- Developed an algorithm using UK clinical guidelines and EHR data.
- Applied the algorithm to a large dataset of over 500,000 patient records.
- Validated findings with manual record reviews.
Main Results:
- Identified 11,097 CKD patients from 532,409 records.
- Found 3,766 patients (34%) with potential for improved BP care (medication or monitoring).
- Achieved a 90% positive-predictive value in manual accuracy evaluations.
Conclusions:
- The developed algorithm provides practical, actionable information for quality improvement.
- This approach bridges the gap between clinical audit and decision support for chronic disease management.
- Algorithms can enhance the management of chronic conditions through data-driven insights.
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