Electronically reporting quality measures may not produce valid data, according to a study in Annals of Internal Medicine.
Researchers compared manual review and electronic reporting of 12 quality measures for adult patients at a federally qualified health center with an electronic health record in 2008. Electronic reporting yielded significantly different results compared with manual review for three measures:
• Data from electronic reporting showed the rate of appropriate asthma medication was 33 percent compared with 77 percent reported through manual review.
• Data from electronic reporting showed the rate of pneumococcal vaccination was 27 percent compared with 48 percent from manual review.
• Data from electronic reporting showed cholesterol control in patients with diabetes was 57 percent compared with 37 percent from manual review.
The data also revealed wide ranges in sensitivity, specificity and predictive values of electronic reporting for each measure:
• The sensitivity of electronic reporting ranged from 46 percent to 98 percent.
• Specificity ranged from 62 percent to 97 percent.
• Positive predictive value ranged from 57 percent to 97 percent.
• Negative predictive value ranged from 32 percent to 99 percent.
The results have important implications for CMS' Medicare and Medicaid Electronic Health Record Incentive Program: "If variation is not addressed, financial incentives intended to reward high quality may not be given to the highest-quality providers," the authors wrote.
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Researchers compared manual review and electronic reporting of 12 quality measures for adult patients at a federally qualified health center with an electronic health record in 2008. Electronic reporting yielded significantly different results compared with manual review for three measures:
• Data from electronic reporting showed the rate of appropriate asthma medication was 33 percent compared with 77 percent reported through manual review.
• Data from electronic reporting showed the rate of pneumococcal vaccination was 27 percent compared with 48 percent from manual review.
• Data from electronic reporting showed cholesterol control in patients with diabetes was 57 percent compared with 37 percent from manual review.
The data also revealed wide ranges in sensitivity, specificity and predictive values of electronic reporting for each measure:
• The sensitivity of electronic reporting ranged from 46 percent to 98 percent.
• Specificity ranged from 62 percent to 97 percent.
• Positive predictive value ranged from 57 percent to 97 percent.
• Negative predictive value ranged from 32 percent to 99 percent.
The results have important implications for CMS' Medicare and Medicaid Electronic Health Record Incentive Program: "If variation is not addressed, financial incentives intended to reward high quality may not be given to the highest-quality providers," the authors wrote.
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