quality of health
Perez-Cuevas R et al, BMC medical informatics and decision making, 12(1)
BACKGROUND:
Several low and middle-income countries are implementing electronic health records (EHR). In the near future, EHRs could become an efficient tool to evaluate healthcare performance if appropriate indicators are developed. The aims of this study are: a) to develop quality of care indicators (QCIs) for type 2 diabetes (T2DM) in the Mexican Institute of Social Security (IMSS) health system; b) to determine the feasibility of constructing QCIs using the IMSS EHR data; and c) to evaluate the quality of care (QC) provided to IMSS patients with T2DM.
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Published:
6 June 2012 |
Keyword(s): Diabetes Mellitus Type 2, Electronic healthcare records, Evaluation, Mexico, Quality of Health Care
Geissbühler A.
Our complex healthcare systems are fragmented, and their functioning, both in terms of efficiency and quality, are plagued by multiple discontinuities. eHealth has the potential to ease transitions between the many settings and stakeholders of healthcare. eHealth can improve the continuity of healthcare information flow, can facilitate the re-engineering of care processes so that they become much more patient-owned and patient-controlled, and can enable better ways of accessing and producing care.
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Published:
6 June 2012 |
Keyword(s): Clinical Information Systems, e-Health, Health Information Exchange, Patient Empowerment, Quality of Health Care, Safety
Kern LM, Applied Clinical Informatics, 3(2)
Background:
Health information exchange is a national priority, but there is limited evidence of its effectiveness.
Objective:
We sought to determine the effect of health information exchange on ambulatory quality.
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Published:
30 May 2012 |
Keyword(s): Effectiveness, Health Information Exchange, Primary Care, Quality of Health Care
Weiner JP et al, International Journal for Quality in Health Care, 24(3)
Measures of provider success are the centerpiece of quality improvement and pay-for-performance programs around the globe. In most nations, these measures are derived from administrative records, paper charts and consumer surveys; increasingly, electronic patient record systems are also being used. We use the term ‘e-QMs’ to describe quality measures that are based on data found within electronic health records and other related health information technology (HIT).
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Published:
6 April 2012 |
Keyword(s): Electronic Health Records, Health Information Technology, Meaningful Use, Performance, Quality of Health Care, United States
Linder JA et al, J Am Med Inform Assoc, 2012
Objective
Physicians who more intensively interact with electronic health records (EHRs) through their documentation style may pay greater attention to coded fields and clinical decision support and thus may deliver higher quality care. We measured the quality of care of physicians who used three predominating EHR documentation styles: dictation, structured documentation, and free text.
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Published:
19 May 2012 |
Keyword(s): Documentation, Electronic Health Records, Patient Safety, Physicians, Primary Care, Quality of Health Care
Herrin J et al, Health Services Research, 2012
Objective
To assess the impact of electronic health record (EHR) implementation on primary care diabetes care.
Data Sources
Charts were abstracted semi-annually for 14,051 diabetes patients seen in 34 primary care practices in a large, fee-for-service network from January 1, 2005 to December 31, 2010. The study sample was limited to patients aged 40 years or older.
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Published:
17 January 2012 |
Keyword(s): Diabetes Mellitus Type 2, Electronic Health Records, Implementation, Primary Care, Quality of Health Care, United States
Wagner PJ et al, J Am Med Inform Assoc, 2012
Purpose
To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services.
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Published:
10 January 2012 |
Keyword(s): Electronic Health Records, Hypertension, Patient Empowerment, Personal Health Records, Quality of Health Care, United States
Kutney-Lee A, Kelly D. The Journal of Nursing Administration, 41(11)
The aim of this study was to examine the effect of having a basic electronic health record (EHR) on nurse-assessed quality of care, including patient safety. Few large-scale studies have examined how adoption of EHRs may be associated with quality of care. A cross-sectional, secondary analysis of nurse and hospital survey data was conducted. The final sample included 16,352 nurses working in 316 hospitals in 4 states.
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Published:
November 2011 |
Keyword(s): Adoption, Electronic Health Records, Hospitals, Nurses, Patient Safety, Quality of Health Care, United States
Jean-Jacques M et al, Journal of General Internal Medicine, 2011
BACKGROUND
Health information technology (HIT)-supported quality improvement initiatives have been shown to increase ambulatory care quality for several chronic conditions and preventive services, but it is not known whether these types of initiatives reduce disparities.
OBJECTIVES
To examine the effects of a multifaceted, HIT-supported quality improvement initiative on disparities in ambulatory care.
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Published:
3 September 2011 |
Keyword(s): Ambulatory Care, Disparities, Health Information Technology, Quality of Health Care, United States
Cebul RD et al, N Engl J Med, 365(9)
Background
Available studies have shown few quality-related advantages of electronic health records (EHRs) over traditional paper records. We compared achievement of and improvement in quality standards for diabetes at practices using EHRs with those at practices using paper records. All practices, including many safety-net primary care practices, belonged to a regional quality collaborative and publicly reported performance.
Methods
We used generalized estimating equations to calculate the percentage-point difference between EHR-based and paper-based practices with respect to achievement of composite standards for diabetes care (including four component standards) and outcomes (five standards), after adjusting for covariates and accounting for clustering. In addition to insurance type (Medicare, commercial, Medicaid, or uninsured), patient-level covariates included race or ethnic group (white, black, Hispanic, or other), age, sex, estimated household income, and level of education. Analyses were conducted separately for the overall sample and for safety-net practices.
Results
From July 2009 through June 2010, data were reported for 27,207 adults with diabetes seen at 46 practices; safety-net practices accounted for 38% of patients. After adjustment for covariates, achievement of composite standards for diabetes care was 35.1 percentage points higher at EHR sites than at paper-based sites (P<0.001), and achievement of composite standards for outcomes was 15.2 percentage points higher (P=0.005). EHR sites were associated with higher achievement on eight of nine component standards. Such sites were also associated with greater improvement in care (a difference of 10.2 percentage points in annual improvement, P<0.001) and outcomes (a difference of 4.1 percentage points in annual improvement, P=0.02). Across all insurance types, EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes care. Results confined to safety-net practices were similar.
Conclusions
These findings support the premise that federal policies encouraging the meaningful use of EHRs may improve the quality of care across insurance types.
Published:
1 September 2011 |
Keyword(s): Diabetes Mellitus, Electronic Health Records, Quality of Health Care, United States
O'Connor PJ et al, Annals of Family Medicine, 9(1)
PURPOSE
We wanted to assess the impact of an electronic health record-based diabetes clinical decision support system on control of hemoglobin A1c (glycated hemoglobin), blood pressure, and low-density lipoprotein (LDL) cholesterol levels in adults with diabetes.
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Published:
1 January 2011 |
Keyword(s): Clinical decision support, Diabetes Mellitus, Electronic Health Records, Primary Care, Quality Improvement, Quality of Health Care, United States
Lau F et al, J Am Med Inform Assoc, 17(6)
The purpose of this review is to consolidate existing evidence from published systematic reviews on health information system (HIS) evaluation studies to inform HIS practice and research. Fifty reviews published during 1994-2008 were selected for meta-level synthesis. These reviews covered five areas: medication management, preventive care, health conditions, data quality, and care process/outcome. After reconciliation for duplicates, 1276 HIS studies were arrived at as the non-overlapping corpus. On the basis of a subset of 287 controlled HIS studies, there is some evidence for improved quality of care, but in varying degrees across topic areas. For instance, 31/43 (72%) controlled HIS studies had positive results using preventive care reminders, mostly through guideline adherence such as immunization and health screening. Key factors that influence HIS success included having in-house systems, developers as users, integrated decision support and benchmark practices, and addressing such contextual issues as provider knowledge and perception, incentives, and legislation/policy.
Published:
1 November 2010 |
Keyword(s): Health Information Systems, Preventive Care, Quality of Health Care, Review
Simon SR et al, Journal of Evaluation in Clinical Practice, 14(1)
Background
Limited data exist to estimate the use of electronic health records (EHRs) in ambulatory care practices in the United States.
Methods
We surveyed a stratified random sample of 1829 office practices in Massachusetts in 2005. The one-page survey measured use of health information technology, plans for EHR adoption and perceived barriers to adoption.
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Published:
February 2008 |
Keyword(s): Electronic Health Records, Health Information Technology, Patient Safety, Quality of Health Care, United States
Nirel N et al, International journal of medical informatics, 2010
PURPOSE:
In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK’s use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals.
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Published:
23 July 2010 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Health Information Technology, Hospitals, Israel, Quality of Health Care
Welch WP et al, J Am Med Inform Assoc, 14(3)
OBJECTIVE:
To assess the impact of the electronic health record (EHR) on cost (i.e., payments to providers) and process measures of quality of care.
STUDY DESIGN:
Retrospective before-after-study-control. From the database of a large managed care organization (MCO), we obtained the claims of patients from four community physician practices that implemented the EHR and from about 50 comparison practices without the EHR in the same counties. The diverse patient and practice populations were chosen to be a sample more representative of typical private practices than has previously been studied.
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Published:
28 February 2007 |
Keyword(s): Costs, Electronic Health Records, Health Information Technology, Quality of Health Care, Retrospective Studies, United States
Tang PC et al, J Am Med Inform Assoc, 14(1)
New reimbursement policies and pay-for-performance programs to reward providers for producing better outcomes are proliferating. Although electronic health record (EHR) systems could provide essential clinical data upon which to base quality measures, most metrics in use were derived from administrative claims data. We compared commonly used quality measures calculated from administrative data to those derived from clinical data in an EHR based on a random sample of 125 charts of Medicare patients with diabetes.
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Published:
January 2007 |
Keyword(s): Blood Pressure, Diabetes Mellitus, Electronic Health Records, Quality of Health Care, United States
Zhou YY et al, Health Affairs, 29(7)
The American Recovery and Reinvestment Act identified secure patient-physician e-mail messaging as an objective of the meaningful use of electronic health records. In our study of 35,423 people with diabetes, hypertension, or both, the use of secure patient-physician e-mail within a two-month period was associated with a statistically significant improvement in effectiveness of care as measured by the Healthcare Effectiveness Data and Information Set (HEDIS).
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Published:
1 July 2010 |
Keyword(s): Chronic Care, e-Mail, Effectiveness, Electronic Health Records, Meaningful Use, Patient-clinician communication, Primary Care, Quality of Health Care, Secure web communications, United States
Crosson JC et al, Annals of Family Medicine, 5(3)
PURPOSE:
Care of patients with diabetes requires management of complex clinical information, which may be improved by the use of an electronic medical record (EMR); however, the actual relationship between EMR usage and diabetes care quality in primary care settings is not well understood. We assessed the relationship between EMR usage and diabetes care quality in a sample of family medicine practices.
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Published:
May 2007 |
Keyword(s): Diabetes Mellitus, Electronic Health Records, Electronic Medical Records, Family Practice, Primary Care, Quality of Health Care
Chiang J et al, J Am Med Inform Assoc, 17(3)
The objective of this study was to develop and validate an automated acquisition system to assess quality of care (QC) measures for cardiovascular diseases. This system combining searching and retrieval algorithms was designed to extract QC measures from electronic discharge notes and to estimate the attainment rates to the current standards of care. It was developed on the patients with ST-segment elevation myocardial infarction and tested on the patients with unstable angina/non-ST-segment elevation myocardial infarction, both diseases sharing almost the same QC measures.
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Published:
May 2010 |
Keyword(s): Cardiovascular Diseases, Discharge Summary, Evaluation, Quality of Health Care
Sweidan M, et al, BMC Medical Informatics and Decision Making, 10(1)
Background
Electronic prescribing is increasingly being used in primary care and in hospitals. Studies on the effects of e-prescribing systems have found evidence for both benefit and harm. The aim of this study was to identify features of e-prescribing software systems that support patient safety and quality of care and that are useful to the clinician and the patient, with a focus on improving the quality use of medicines.
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Published:
15 April 2010 |
Keyword(s): Australia, Decision Support, Electronic Prescribing, Hospitals, Literature Review, Patient Data, Patient Safety, Primary Care, Quality of Health Care
