Electronically Reported Quality Measures Vary in Accuracy, Study Finds

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Electronically reported clinical quality measures tend to vary widely in accuracy, a trend that could undermine the success of the meaningful use program, according to a study published Tuesday in the Annals of Internal Medicine, Modern Physician reports.

Background

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

Starting in 2014, participants in the meaningful use program will be required to submit quality data using EHR systems.

Most clinical quality reporting initiatives currently rely on administrative billing data or manual record review (McKinney, Modern Physician, 1/15).

Study Details

The study was conducted by researchers at Weill Cornell Medical College and funded by the Agency for Healthcare Research and Quality (Gold, FierceEMR, 1/16).

For the study, researchers analyzed 2008 data on more than 1,100 patients who received treatment at a federally qualified health center.

Researchers specifically looked at 12 quality measures, 11 of which overlap with measures under Stage 1 of the meaningful use program and 10 of which overlap with Stage 2 measures. They then compared the electronically reported quality measures with data from a manual record review (Modern Physician, 1/15).

Study Findings

The study found that the electronically reported data were consistent with manual record review for nine measures.

However, it also found that that the electronically reported data:

  • Underestimated the percentage of patients who received prescriptions for asthma;
  • Underestimated the percentage of patients who received pneumococcal vaccinations; and
  • Overestimated the percentage of patients with diabetes who had their cholesterol under control (Miliard, Healthcare IT News, 1/16).

Comments on Findings

The study authors noted that these discrepancies could affect the success of the meaningful use program. They wrote, "If electronic reports are not proven to be accurate, their ability to change physicians' behavior to achieve higher quality, the underlying goal [of the meaningful use program], will be undermined."

To improve the accuracy and efficacy of electronically reported quality measures, the researchers recommended:

  • Increasing the use of structured fields in EHR systems; and
  • Adopting quality measures that are designed specifically for electronic reporting (Modern Physician, 1/15).
Protima Advani
Worth noting that CMS was clear that it didnt expect providers to manually enter data from charts into the EHR for accurate CQM reporting. They didnt want to add to the reporting burden for providers and recognized that in the early years of the program, when providers do not have system adoption across the hospital, there will be data captured on patients in charts and hence dilute the electronic computation of the CQMs for MU reporting. So these findings are not surprising at all.

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