New Ways Of Leveraging EMRs For Quality Measurement

Posted on June 7, 2012 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Helping to measure care quality is supposed to be one of the best tricks EMRs can do. After all, EMRs can round up data in seconds that would take weeks or months to abstract from a paper chart. More importantly, they can pick up patterns that paper charts don’t contain, such as the speed at which some behaviors take place.

The thing is, most providers are still taking little advantage of EMRs’ quality research functions, according to a new study published in the International Journal for Quality in Health Care.  Researchers point out that while EMRs can capture many classes information, most of the time users are limiting themselves to measures lifted from paper-based research studies. They propose creating a new set of measurements known as electronic quality measures, or e-QMs.  Here’s how Information Week summarizes the measures:

Translated e-QMs. Measures designed for use with paper records, such as whether patients with diabetes have received HbA1c tests. These measures can use claims data or information from chart abstraction, as well as EHRs.

–Health IT-assisted. Measures that could be derived from non-EHR data sources, such as blood pressure or body mass index information, but that require EHRs for reporting on 100% of a patient population.

–Health IT-enabled. Metrics that take advantage of an EHR’s features, such as the percentage of abnormal test results read and acted upon by a clinician within 24 hours of receipt, or the percentage of relevant clinical alerts that are acted upon.

–Health IT system management. Measures of how providers use health IT systems, such as the percentage of all prescriptions ordered via electronic prescribing.

–E-iatrogenesis. Measures of patient harm caused at least in part by the health IT system, such as the percentage of patients for whom the wrong drug was ordered because of an error in an e-prescribing system, or the percentage of critical lab findings that did not lead to patient notification.

This sounds pretty neat, and with any luck, most providers will end up using their EMRs to conduct more-thorough measurements of this type.  At the moment, though, less than a quarter of all care is “substantially documented,” and only half of U.S. doctors have some form of EHR, according to the researchers.

In the mean time, let’s hope providers who do have advanced EMR installations are taking steps like these. They make a lot of sense.