Background: The federal Electronic Health Record Incentive Program requires electronic reporting of quality from electronic health records, beginning in 2014. Whether electronic reports of quality are accurate is unclear.
Objective: To measure the accuracy of electronic reporting compared with manual review.
Design: Cross-sectional study.
Setting: A federally qualified health center with a commercially available electronic health record.
Patients: All adult patients eligible in 2008 for 12 quality measures (using 8 unique denominators) were identified electronically. One hundred fifty patients were randomly sampled per denominator, yielding 1154 unique patients.
Measurements: Receipt of recommended care, assessed by both electronic reporting and manual review. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and absolute rates of recommended care were measured.
Results: Sensitivity of electronic reporting ranged from 46% to 98% per measure. Specificity ranged from 62% to 97%, positive predictive value from 57% to 97%, and negative predictive value from 32% to 99%. Positive likelihood ratios ranged from 2.34 to 24.25 and negative likelihood ratios from 0.02 to 0.61. Differences between electronic reporting and manual review were statistically significant for 3 measures: Electronic reporting underestimated the absolute rate of recommended care for 2 measures (appropriate asthma medication [38% vs. 77%; P < 0.001] and pneumococcal vaccination [27% vs. 48%; P < 0.001]) and overestimated care for 1 measure (cholesterol control in patients with diabetes [57% vs. 37%; P = 0.001]).
Limitation: This study addresses the accuracy of the measure numerator only.
Conclusion: Wide measure-by-measure variation in accuracy threatens the validity of electronic reporting. If variation is not addressed, financial incentives intended to reward high quality may not be given to the highest-quality providers.
Primary Funding Source: Agency for Healthcare Research and Quality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.7326/0003-4819-158-2-201301150-00001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Curative-Intended Management of Synchronous Esophageal and Rectal Cancer-A Systematic Literature Review.
J Gastrointest Cancer
January 2025
Department of Radiotherapy and Radiation Oncology, Jena University Hospital, 07747, Jena, Germany.
Purpose: Synchronous esophageal (EC) and rectal carcinoma (RC) is a rare and challenging condition, particularly in curative-intended treatment. Especially locally advanced tumors may not be suitable for primary resection and require individual multimodal treatment. This review examines curative-intended management of synchronous EC and RC.
View Article and Find Full Text PDFComparison of precision of a paperless electronic input method versus the conventional paper form in an andrology laboratory: a prospective study.
Basic Clin Androl
January 2025
Department of Obstetrics and Gynaecology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, Hong Kong.
Background: Manual counting for semen analysis is recommended by the World Health Organization. Technicians performing this usually record their results on a paper worksheet and then enter the data into an electronic laboratory information system. One disadvantage of this approach is the chance of post-analytical transcription errors, which can be reduced by checking the computer entries before reporting by another technician.
View Article and Find Full Text PDFCase report: Immediate and sustained relief of postherpetic neuralgia with erector spinae nerve block in a 60-year-old woman.
Am J Emerg Med
December 2024
University of California, Los Angeles - Department of Emergency Medicine, United States of America. Electronic address:
Introduction: The erector spinae plane block (ESPB) is a relatively new regional anesthetic procedure that provides analgesia below the erector spinae muscles in an interfascial plane. The indications for its use continue to expand as we learn more about this block.
Case: We report a case of a 60 year old woman presenting to the emergency department (ED) with severe intractable pain after recent onset of herpes zoster infection.
Deferred cytoreductive nephrectomy in patients with metastatic renal cell carcinoma: A systematic review and patient-level meta-analysis.
Urol Oncol
January 2025
Department of Urology, Singapore General Hospital, Singapore; SingHealth Duke-NUS Transplant Centre, Singapore. Electronic address:
There has been much controversy regarding the order in which cytoreductive nephrectomy (CN) and systemic therapy (ST) are applied for patients with metastatic renal cell carcinoma (mRCC). We aimed to investigate the role of deferred CN (dCN) in mRCC, particularly in the current era of immunotherapy. A systematic literature search was conducted on PubMed, Embase, and Scopus for studies comparing dCN versus any non-dCN strategy, in any temporal sequence, with the provision of Kaplan-Meier curves for overall survival (OS).
View Article and Find Full Text PDFImmediate second resection versus restage transurethral resection of bladder tumor: A prospective randomized clinical trial (IMMERSE trial).
Urol Oncol
January 2025
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Background: The role of repeat transurethral resection of bladder tumor (TURBT) for the management of nonmuscle invasive bladder carcinoma is debated, especially when initial resections include detrusor muscle. This study compares immediate second resection (additional deep biopsies in the same session) with standard restage TURBT performed 2-6 weeks post-initial TURBT to determine adequacy in detrusor muscle sampling and compare the disease rate at restage TURBT in both groups.
Material And Methods: A randomized trial was conducted at a tertiary care hospital, including patients aged ≥18 years undergoing TURBT with complete primary tumor resection.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!