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Using a stakeholder-engaged approach to develop and validate electronic clinical quality measures.

Jill Boylston Herndon¹, Krishna Aravamudhan², Ronald L Stephenson³

¹Key Analytics and Consulting, LLC, Gainesville, Florida, USA (Dr Herndon was with the Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida, USA, when this study was conducted).

Journal of the American Medical Informatics Association : JAMIA

|March 25, 2017

Summary

Stakeholder engagement successfully developed and validated two oral health electronic clinical quality measures. This collaborative approach ensured feasibility, reliability, and validity, leading to published measures.

Keywords:

electronic health records health care quality indicators meaningful use quality measure development quality measure testing

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Area of Science:

Health Services Research
Quality Improvement Science
Dental Informatics

Background:

Developing robust electronic clinical quality measures (eCQMs) is crucial for improving oral healthcare.
Previous efforts may have lacked comprehensive stakeholder input, potentially impacting measure utility and adoption.

Purpose of the Study:

To detail the stakeholder-engaged methodology for creating and validating two oral health eCQMs.
To demonstrate a process for ensuring the feasibility, reliability, and validity of eCQMs.

Main Methods:

Engaged diverse stakeholders throughout the measure development lifecycle, from conception to testing.
Assessed data element feasibility via interviews and utilized synthetic patient datasets for implementation testing across electronic health record (EHR) systems.
Validated measure implementation using automated EHR data reporting compared to manual record reviews, employing the kappa statistic.

Main Results:

A dedicated stakeholder workgroup guided all development and testing phases.
All critical data elements passed feasibility assessments, and measure implementation was proven feasible in EHRs.
High reliability and validity were confirmed, with kappa statistics indicating "almost perfect" to "substantial" agreement, and the measures were published.

Conclusions:

Stakeholder engagement is vital for successful eCQM development and testing.
Early and continuous stakeholder involvement mitigates risks to feasibility, reliability, and validity, optimizing resource allocation.