Applied Use of Composite Quality Measures for EHR-enabled Practices.

Introduction: The Primary Care Information Project (PCIP) of the New York City Department of Health and Mental Hygiene has been assisting providers to implement health information technology such as electronic health records (EHRs) since its founding in 2005. Currently, all practices affiliated with PCIP are offered technical support services in order to improve the use of the EHR. We studied the performance of clinical practices on EHR-derived Composite Quality Measures (CQMs) over time.

Developing Composite Quality Measures for EHR-Enabled Primary Care Practices in New York City.

We describe the process of developing composite quality measures (CQMs). During the initial consultative process, we grouped quality measures based on the associated clinical workflow and difficulty, and then confirmed the groupings with factor analysis. The CQMs are estimated as the mean of the measures for each group.

Patient Characteristics Associated With Smoking Cessation Interventions and Quit Attempt Rates Across 10 Community Health Centers With Electronic Health Records.

Objectives: We used electronic health record (EHR) data to determine rates and patient characteristics in offering cessation interventions (counseling, medications, or referral) and initiating quit attempts.

Methods: Ten community health centers in New York City contributed 30 months of de-identified patient data from their EHRs.

Results: Of 302 940 patients, 40% had smoking status recorded and only 34% of documented current smokers received an intervention.

Increases in smoking cessation interventions after a feedback and improvement initiative using electronic health records -- 19 community health centers, New York City, October 2010-March 2012.

Quitting smoking substantially reduces smokers' risk for smoking-related morbidity and mortality and can increase life expectancy by up to a decade. Most smokers want to quit and make at least one medical provider visit annually. Health care providers can play an important role in helping smokers quit by documenting patients' tobacco use, advising smokers to quit, and providing evidence-based cessation treatments or referrals for treatment, but many providers and practices do not regularly take these actions.

Designing a quality improvement program with electronic health records: New York City's Health eQuits.

Despite clear recommendations for identifying and intervening with smokers, clinical preventive practice is inconsistent in primary care. Use of electronic health records could facilitate improvement. Community health centers treating low-income and Medicaid recipients with greater smoking prevalence than the general population were recruited for a pilot program.

Patient experiences at primary care practices using electronic health records.

We assessed patient experiences before and one year after electronic health record (EHR) implementation among primary care practices in New York City. These practices represented an ethnically diverse population in lower-income, urban communities. Surveys, available in English, Spanish, and Chinese languages, were administered at 10 sites.

Skeletal consequences of hormone therapy discontinuance: a systematic review.

Unlabelled: Although hormone therapy protects against bone loss after menopause, currently it is not recommended once menopausal symptoms have subsided. We reviewed randomized clinical trials to quantify bone loss after stopping hormone therapy and summarize treatment options for women who discontinue hormone treatment. We conducted a search of MEDLINE and EMBASE for randomized, controlled trials measuring bone mineral density (BMD) after hormone therapy discontinuation.

The effect of raloxifene on the incidence of ovarian cancer in postmenopausal women.

Objective: The aim of this study was to determine the incidence of ovarian cancer in postmenopausal women treated with raloxifene compared with placebo.

Methods: This analysis comprises integrated data from seven randomized, placebo-controlled trials of raloxifene (N = 9837). Ovarian cancer cases were identified from the safety database and reviewed by a gynecologic adjudication review board.