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The Age-Friendly Learning Healthcare System: Replicating electronic health record based documentation metrics for 4Ms
Jorie M Butler1,2,3,4, Timothy W Farrell2,3, Megan Puckett2
1Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Journal of the American Geriatrics Society
|December 13, 2024
Summary
University of Utah Health successfully adapted electronic health record (EHR) metrics to assess age-friendly care (the 4Ms: What Matters, Medication, Mentation, and Mobility) in older patients. This demonstrates EHR data
Area of Science:
- Geriatric Medicine
- Health Services Research
- Health Informatics
Background:
- University of Utah Health (UUH) is committed to age-friendly care excellence.
- University of California San Francisco (UCSF) developed electronic health record (EHR) metrics for the 4Ms (What Matters, Medication, Mentation, Mobility) for age-friendly care.
- UUH partnered with UCSF to adapt and implement these EHR metrics locally.
Purpose of the Study:
- To replicate and adapt UCSF's EHR documentation metrics for assessing the 4Ms at UUH.
- To evaluate the completeness of age-friendly care delivery using EHR data.
- To identify key lessons for scaling up the assessment of age-friendly care across academic medical centers.
Main Methods:
- Adapted UCSF's EHR metrics and SQL code for UUH's local clinical context and database system.
- Assessed 4Ms care for patients aged 65+ admitted to UU Hospital between January 2019 and December 2021.
- Conducted clinical validation of EHR queries to ensure accuracy of 4Ms assessment.
Main Results:
- Replicated 14 of 16 individual EHR metrics and developed five composite measures.
- Analyzed 25,070 admissions for 16,489 patients aged 65 and older.
- Found that 50% of patient encounters had all 4Ms administered, indicating room for improvement in care completeness.
Conclusions:
- EHR data can effectively measure the completeness of 4Ms care implementation at academic medical centers.
- Adapting EHR measures to local clinical activities and involving data analysts are crucial for successful implementation.
- This study validates the use of EHR metrics for quality improvement in age-friendly healthcare systems.
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