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Application of a digital quality measure for cancer diagnosis in Epic Cosmos
Andrew J Zimolzak1,2, Sundas P Khan1,2, Hardeep Singh1,2
1Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) and Baylor College of Medicine, Houston, TX 77030, United States.
Objectives:
Missed and delayed cancer diagnoses are common, harmful, and often preventable. We previously validated a digital quality measure (dQM) of emergency presentation (EP) of lung cancer in 2 US health systems. This study aimed to apply the dQM to a new national electronic health record (EHR) database and examine demographic associations.
Materials And Methods:
We applied the dQM (emergency encounter followed by new lung cancer diagnosis within 30 days) to Epic Cosmos, a deidentified database covering 184 million US patients. We examined dQM associations with sociodemographic factors.
Results:
The overall EP rate was 19.6%. EP rate was higher in Black vs White patients (24% vs 19%, P < .001) and patients with younger age, higher social vulnerability, lower-income ZIP code, and self-reported transport difficulties.
Discussion:
We successfully applied a dQM based on cancer EP to the largest US EHR database.
Conclusion:
This dQM could be a marker for sociodemographic vulnerabilities in cancer diagnosis.
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