Document Detail


The impact of electronic medical records data sources on an adverse drug event quality measure.
MedLine Citation:
PMID:  20190062     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the impact of billing and clinical data extracted from an electronic medical record system on the calculation of an adverse drug event (ADE) quality measure approved for use in The Joint Commission's ORYX program, a mandatory national hospital quality reporting system.
DESIGN: The Child Health Corporation of America's "Use of Rescue Agents-ADE Trigger" quality measure uses medication billing data contained in the Pediatric Health Information Systems (PHIS) data warehouse to create The Joint Commission-approved quality measure. Using a similar query, we calculated the quality measure using PHIS plus four data sources extracted from our electronic medical record (EMR) system: medications charged, medication orders placed, medication orders with associated charges (orders charged), and medications administered.
MEASUREMENTS: Inclusion and exclusion criteria were identical for all queries. Denominators and numerators were calculated using the five data sets. The reported quality measure is the ADE rate (numerator/denominator).
RESULTS: Significant differences in denominators, numerators, and rates were calculated from different data sources within a single institution's EMR. Differences were due to both common clinical practices that may be similar across institutions and unique workflow practices not likely to be present at any other institution. The magnitude of the differences would significantly alter the national comparative ranking of our institution compared to other PHIS institutions.
CONCLUSIONS: More detailed clinical information may result in quality measures that are not comparable across institutions due institution-specific workflow, differences that are exposed using EMR-derived data.
Authors:
Michael G Kahn; Daksha Ranade
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Medical Informatics Association : JAMIA     Volume:  17     ISSN:  1527-974X     ISO Abbreviation:  J Am Med Inform Assoc     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-06-08     Revised Date:  2011-07-26    
Medline Journal Info:
Nlm Unique ID:  9430800     Medline TA:  J Am Med Inform Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-91     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Colorado Denver, Aurora, Colorado 80045, USA. Michael.Kahn@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
Adverse Drug Reaction Reporting Systems*
Electronic Health Records*
Humans
Information Storage and Retrieval*
Joint Commission on Accreditation of Healthcare Organizations
Quality Assurance, Health Care / methods*
United States
Workflow
Grant Support
ID/Acronym/Agency:
1 UL1 RR 025780/RR/NCRR NIH HHS
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