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A computerized system for reviewing medical records from physicians' offices
D W Garnick1, A G Lawthers, R H Palmer
1Institute for Health Policy, Heller Graduate School, Brandeis University, Waltham, MA 02254-9110.
The Joint Commission Journal on Quality Improvement
|December 1, 1994
Summary
Assessing office-based care quality is vital. The DEMPAQ Record Review System (DRRS) offers a cost-effective method for peer review organizations (PROs) to evaluate ambulatory care, with costs under $72 per case.
Area of Science:
- Healthcare Quality Improvement
- Ambulatory Care Assessment
- Medical Record Review
Background:
- Increasing shift of medical care to outpatient settings necessitates robust office-based care quality reviews.
- Primary care decisions significantly impact patient outcomes through prevention and early intervention.
- Objective quality data from medical records is crucial for managed care organizations and clinical decision-making.
Purpose of the Study:
- To introduce the DEMPAQ Record Review System (DRRS) for evaluating ambulatory care quality in physicians' offices.
- To provide a framework for measuring the operational costs associated with medical record review systems.
Main Methods:
- The DRRS utilizes functions, indicators, and clinical items to assess care quality for Medicare beneficiaries.
- A total of 263 indicators are employed to measure various aspects of clinical care.
- The study outlines a cost-measurement framework for record review systems.
Main Results:
- Operational costs for the DRRS were below $72 per case in studied regions.
- Reviewer time averaged one hour per case, decreasing with practice.
- Administrative costs constitute about half of the total review process expenses.
Conclusions:
- The cost of collecting quality data via the DRRS is within the budget for peer review organizations (PROs).
- Organizations should factor in additional costs for data analysis, physician reporting, and performance monitoring for quality improvement campaigns.