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Developing Composite Quality Measures for EHR-Enabled Primary Care Practices in New York City.
The Journal of Medical Practice Management : MPM
|July 31, 2015
Summary
Developing composite quality measures (CQMs) involves grouping and averaging individual measures. Practice performance on CQMs improved significantly over time, with performance gaps narrowing between 2009 and 2011.
Area of Science:
- Healthcare Quality Improvement
- Health Informatics
- Clinical Performance Measurement
Background:
- Composite quality measures (CQMs) are crucial for evaluating healthcare performance.
- Grouping individual quality measures by clinical workflow and difficulty aids in developing robust CQMs.
- Understanding factors influencing practice performance is essential for targeted interventions.
Purpose of the Study:
- To describe the development process of composite quality measures (CQMs).
- To assess performance trends and differences among four specific CQMs from 2009 to 2011.
- To identify factors influencing practice performance related to CQMs.
Main Methods:
- Quality measures were grouped based on clinical workflow and difficulty, confirmed by factor analysis.
- Composite quality measures (CQMs) were estimated as the mean of measures within each group.
- Analysis of variance (ANOVA) and post hoc analysis were used to assess yearly performance and trends.
Main Results:
- Four CQMs were developed: Control-BP, Control-Other, Assessment, and Screening.
- Baseline performance was highest for Control-BP (58%), followed by Control-Other (48%), Screening (46%), and Assessment (42%).
- Performance on all CQMs significantly increased over time, and the performance gap between CQMs decreased.
Conclusions:
- The developed CQMs effectively reflect clinical care domains.
- Practice performance on CQMs is influenced by electronic health record functionality, clinician workflow, and clinical difficulty.
- CQM development and analysis provide valuable insights into healthcare quality improvement.
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