Measuring Preventive Care Delivery: Comparing Rates Across Three Data Sources.

Area of Science:

• Health Services Research
• Health Informatics
• Quality Improvement

Background:

• Preventive care delivery is a key quality metric.
• Electronic data sources are increasingly used to monitor preventive services.
• Validating these electronic sources against manual chart reviews is crucial for accuracy.

Purpose of the Study:

• To assess the validity and completeness of electronic health records (EHRs) and Medicaid claims data for tracking preventive services.
• To compare automated data sources against manual chart review as the gold standard.

Main Methods:

• A cross-sectional study sampled Medicaid patients from 43 community health centers in 2011.
• Manual chart review was compared to EHR extraction and Medicaid claims data.
• Correspondence was measured for ten preventive services (n=150 patients/service).

Main Results:

• EHR extraction showed high agreement (κ=0.96-1.0) for in-primary-care services (e.g., BMI, blood pressure).
• Agreement varied for referred services like cancer screenings (κ=0.42-0.62).
• Medicaid claims demonstrated strong agreement for screenings and vaccinations but missed ordered/unbilled services.

Conclusions:

• Automated EHR and claims data are largely valid for measuring preventive service receipt.
• EHR data is superior for capturing ordered and unbilled services.
• Claims data is more effective for documenting completed referrals.