TY - JOUR
T1 - The feasibility and accuracy of evaluating lipid management performance metrics using an electronic health record
AU - Danford, Christopher P.
AU - Navar-Boggan, Ann Marie
AU - Stafford, Judy
AU - McCarver, Catherine
AU - Peterson, Eric D.
AU - Wang, Tracy Y.
N1 - Funding Information:
This project was supported by grant number U19HS021092 from the Agency for Healthcare Research and Quality. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting of the paper and its final contents, which do not necessarily represent the official views of the Agency for Healthcare Research and Quality.
PY - 2013/10
Y1 - 2013/10
N2 - Background Over the past decade, electronic health records (EHRs) have emerged as a potential tool to assess quality of care; however, the feasibility and accuracy of EHRs to assess adherence to lipid management performance measures have not been evaluated. Methods We created a retrospective cohort of 3779 patients with coronary artery disease who were followed up in a cardiology clinic at an academic medical center using an EHR database. Of these 3779 patients, 300 randomly-selected charts were reviewed to identify reasons for failure to adhere to lipid management performance measures. Results Based on the EHR, a low-density lipoprotein cholesterol measurement was obtained in 73% of patients within the past 3 years; of which, 34% had low-density lipoprotein cholesterol levels ≥100 mg/dL and statin therapy had been prescribed in 88%. Manual chart review revealed that many of these apparent failures were actually false positives, due to inaccurate capture of indications and contraindications to lipid measurement and statin prescription, patient/provider treatment preferences, and external data sources. Conclusions While it is possible to monitor adherence to lipid management performance measures using an EHR, the accuracy of this assessment is currently limited and may underestimate provider quality of care.
AB - Background Over the past decade, electronic health records (EHRs) have emerged as a potential tool to assess quality of care; however, the feasibility and accuracy of EHRs to assess adherence to lipid management performance measures have not been evaluated. Methods We created a retrospective cohort of 3779 patients with coronary artery disease who were followed up in a cardiology clinic at an academic medical center using an EHR database. Of these 3779 patients, 300 randomly-selected charts were reviewed to identify reasons for failure to adhere to lipid management performance measures. Results Based on the EHR, a low-density lipoprotein cholesterol measurement was obtained in 73% of patients within the past 3 years; of which, 34% had low-density lipoprotein cholesterol levels ≥100 mg/dL and statin therapy had been prescribed in 88%. Manual chart review revealed that many of these apparent failures were actually false positives, due to inaccurate capture of indications and contraindications to lipid measurement and statin prescription, patient/provider treatment preferences, and external data sources. Conclusions While it is possible to monitor adherence to lipid management performance measures using an EHR, the accuracy of this assessment is currently limited and may underestimate provider quality of care.
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U2 - 10.1016/j.ahj.2013.07.024
DO - 10.1016/j.ahj.2013.07.024
M3 - Article
C2 - 24093850
AN - SCOPUS:84885174107
SN - 0002-8703
VL - 166
SP - 701
EP - 708
JO - American heart journal
JF - American heart journal
IS - 4
ER -