Measuring Diabetes Care Performance Using Electronic Health Record Data: The Impact of Diabetes Definitions on Performance Measure Outcomes

American Journal of Medical Quality

Volumn 29, Issue 4, 2014, Pages 292-299

  Hirsch, Annemarie Gregory ^a   Scheck McAlearney, Ann ^b  

^a GEISINGER HEALTH SYSTEM   (United States)

^b OHIO STATE UNIVERSITY   (United States)

Author keywords

diabetes; health information technology; performance measurement

Indexed keywords

DIABETES MELLITUS; ELECTRONIC HEALTH RECORD; HEALTH CARE QUALITY; HUMAN; PROCEDURES; STANDARDS; STATISTICS AND NUMERICAL DATA;

DIABETES MELLITUS; ELECTRONIC HEALTH RECORDS; HUMANS; QUALITY ASSURANCE, HEALTH CARE; QUALITY INDICATORS, HEALTH CARE; QUALITY OF HEALTH CARE;

EID: 84904322082     PISSN: 10628606     EISSN: 1555824X     Source Type: Journal    
DOI: 10.1177/1062860613500808     Document Type: Article

References (37)

1. Performance Measurement: Accelerating Improvement. Washington, DC: National Academies Press; 2006:.
2. Iezzoni LI.Assessing quality using administrative data.Ann Intern Med. 1997;127:666-674.
3. Blumenthal D.Launching HITECH.N Engl J Med. 2010;362:382-385.
4. Jha A.Meaningful use of electronic health records: the road ahead.JAMA. 2010;304:1709-1710.
5. Chan KS,Fowles JB,Weiner JP.Electronic health records and the reliability and validity of quality measures: a review of the literature.Med Care Res Rev. 2010;67:503-527.
6. Cimino JJ,Patel VL,Kushniruk AW.Studying the human-computer-terminology interface.J Am Med Inform Assoc. 2001;8:163-173.
7. Terris DC,Litaker DG,Koroukian SM.Health state information derived from secondary databases is affected by multiple sources of bias.J Clin Epidemiol. 2007;60:734-741.
8. Rollason W,Khunti K,de Lusignan S.Variation in the recording of diabetes diagnostic data in primary care systems: implications for the quality of care.Inform Prim Care. 2009;17:113-119.
9. Roth CP,Lim Y,Pevnick JM,Asch SM,McGlynn EA.The challenge of measuring quality of care from the electronic health record.Am J Med Qual. 2009;24:385-394.
10. Seiber EE.Physician code creep: evidence in Medicaid and state employee health insurance billing.Health Care Financ Rev. 2007;28 (4): 83-93.
11. VanGeest J,Weiner S,Johnson T,Cummins D.Impact of managed care on physicians' decisions to manipulate reimbursement rules: an explanatory model.J Health Serv Res Policy. 2007;12:147-152.
12. Wynia M,Cummins DS,VanGeest JB,Wilson IB.Physician manipulation of reimbursement for patients: between a rock and a hard place.JAMA. 2000;283:1858-1865.
13. Hartzband P,Groopman J.Off the record: avoiding the pitfalls of going electronic.N Engl J Med. 2008;358:1656-1658.
14. FowlesJBKindEAAwwadS. Performance measures using electronic health records. http://www.commonwealthfund.org/usr_doc/Briggs_Fowles_perfmeasEHRs5casestudies_1132.pdf?section=4039. Accessed January 2010.
15. Simon SR,McCarthy M,Kaushal R, et al.Electronic health records: which practices have them, and how are clinicians using them?.J Eval Clin Pract. 2008;14:43-47.
16. ASTM. Standard guide for content and structure of the electronic health record (EHR). http://www.musc.edu/infoservices/lanvision/Regulations_Policies_Guidelines/ASTMEMRGuide.pdf. Accessed July 13, 2013.
17. Martirosyan L,Arah OA,Haaijer-Ruskamp F,Braspenning J,Denig P.Methods to identify the target population: implications for prescribing quality indicators.BMC Health Serv Res. 2010;10:137.
18. Hartung D,Hunt J,Siemienczuk J,Miller H,Touchette D.Clinical implications of an accurate problem list on heart failure treatment.J Gen Intern Med. 2005;20:143-147.
19. Leas BF,Berman B,Kash KM, et al.Quality measurement in diabetes care.Popul Health Manag. 2009;12:265-271.
20. Tang PC,Ralston M,Arricotti MF,Qureshi L,Graham J.Comparison of methodologies for calculating quality measures based on administrative data versus clinical data from an electronic health record system: implications for performance measures.J Am Med Inform Assoc. 2007;14:10-15.
21. Tu K,Manuel D,Lam K,Kavanagh D,Mitiku TF,Guo H.Diabetics can be identified in an electronic medical record using laboratory tests and prescriptions.J Clin Epidemiol. 2011;64:431-435.
22. Harris SB,Glazier RH,Tompkins JW, et al.Investigating concordance in diabetes diagnosis between primary care charts (electronic medical records) and health administrative data: a retrospective cohort study.BMC Health Serv Res. 2010;10:347.
23. Shah NR,Hirsch AG,Zacker C,Taylor S,Wood GC,Stewart WF.Factors associated with first-fill adherence rates for diabetic medications: a cohort study.J Gen Intern Med. 2009;24:1497-1525.
24. Centers for Medicare and Medicaid Services. Physician quality reporting initiative: alternative reporting mechanisms. http://www.cms.hhs.gov/PQRI/20_AlternativeReportingMechanisms.asp. Accessed January 2010.
25. Centers for Medicare and Medicaid Services. 2010EHR warehouse measure specifications. http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/downloads/2010_EHR_Measure_Specifications_121809.pdf. Accessed July 13, 2013.
26. Young BA,Lin E,Von Korff M, et al.Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization.Am J Manag Care. 2008;14 (1): 15-24.
27. Marshall MN,Shekelle PG,Leatherman S,Brook RH.The public release of performance data: what do we expect to gain? A review of the evidence.JAMA. 2000;283:1866-1874.
28. Steinman MA,Fischer MA,Shilpak MG, et al.Clinician awareness of adherence to hypertension guidelines.Am J Med. 2004;117:747-754.
29. Hahn K,Ohman-Stickland P,Cohen DJ, et al.Electronic medical records are not associated with improved documentation in community primary care practices.Am J Med Qual. 2011;26:272-277.
30. Hafner JM,Williams SC,Koss RG,Tschurtz BA,Schmaltz SP,Loeb JM.The perceived impact of public reporting hospital performance data: interviews with hospital staff.Int J Qual Health Care. 2011;23:697-704.
31. Chen T,Chung K,Lin I,Lai M.The unintended consequences of diabetes mellitus pay-for-performance (P4P) program in Taiwan: are patients with more comorbidities or more severe conditions likely to be excluded from the P4P program?.Health Serv Res. 2011;46:47-60.
32. Doran T,Fullwood C,Reeves D,Gravelle H,Roland M.Exclusion of patients from pay-for-performance targets by English physicians.N Engl J Med. 2008;359:274-284.
33. Gravelle H,Sutton M,Ma M.Doctor behavior under a pay for performance contract: treating, cheating and case finding?.Economic J. 2010;120:F129-F156.
34. Doran T,Fullwood C,Gravelle H, et al.Pay-for-performance programs in family practices in the United Kingdom.N Engl J Med. 2006;355:375-385.
35. Sigfrid LA,Turner C,Crook D,Ray S.Using the UK primary care quality and outcomes framework to audit health care equity: preliminary data on diabetes management.J Public Health (Oxf). 2006;28:221-225.
36. Federal Coordinating Council for Comparative Effectiveness Research. Report to the President and the Congress. http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. Published June30, 2009. Accessed March 2012.
37. Jha A,DesRoches C,Kralovec P,Joshi M.A progress report on electronic health records in U.S. hospitals.Health Aff (Millwood). 2010;29:1951-1957.