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Applied Use of Composite Quality Measures for EHR-enabled Practices.

Aurora O Amoah1, Sam Amirfar1, Sheryl L Silfen1

  • 1New York City Department of Health and Mental Hygiene.

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|August 21, 2015
PubMed
Summary

Low-performing practices using electronic health records (EHRs) showed the most improvement in quality measures over one year. Targeted technical assistance can further enhance EHR functionality and quality improvement for all practices.

Keywords:
Health Information Technologychronic diseaseelectronic health recordsquality measuresquality of care

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Area of Science:

  • Health Informatics
  • Clinical Quality Improvement
  • Electronic Health Records (EHRs)

Background:

  • The Primary Care Information Project (PCIP) supports healthcare providers in implementing and optimizing EHRs.
  • Technical support services are offered to practices to improve EHR utilization.
  • The study investigates the relationship between EHR functionalities and performance on quality measures.

Purpose of the Study:

  • To analyze the performance of clinical practices on EHR-derived Composite Quality Measures (CQMs) over time.
  • To hypothesize that specific EHR functionalities impact CQM performance.
  • To inform the development of targeted technical assistance for practices.

Main Methods:

  • Four Composite Quality Measures (CQMs) were created: Screening, Assessment, Control-BP, and Control-Other.
  • Performance data from 93 practices were analyzed, categorizing them into premier, average, and low tiers.
  • Statistical tests (dependent t-test, chi-square) examined changes in CQM performance and tier movement.

Main Results:

  • Practices in the low tier demonstrated the most significant gains in CQMs over one year.
  • Premier tier practices showed mixed results, with gains in some measures and losses in others.
  • The Control-Other CQM showed the greatest improvement, with 38% of practices improving their tier.

Conclusions:

  • Targeted technical assistance, informed by EHR functionalities, can improve performance for low-tier practices.
  • Practices with greater familiarity with EHR functionalities have ongoing potential for improvement.
  • Understanding the link between EHR features and quality metrics is crucial for effective support.