Improving Performance on Preventive Health Quality Measures Using Clinical Decision Support to Capture Care Done Elsewhere and Patient Exceptions.
Am J Med Qual
; 33(3): 237-245, 2018.
Article
em En
| MEDLINE
| ID: mdl-29034685
ABSTRACT
Preventive services required for performance measurement often are completed in outside health systems and not captured in electronic medical records (EMRs). A before-after study was conducted to examine the ability of clinical decision support (CDS) to improve performance on preventive quality measures, capture clinician-reported services completed elsewhere, and patient/medical exceptions and to describe their impact on quality measurement. CDS improved performance on colorectal cancer screening, osteoporosis screening, and pneumococcal vaccination measures ( P < .05) but not breast or cervical cancer screening. CDS captured clinician-reported services completed elsewhere (2% to 10%) and patient/medical exceptions (<3%). Compared to measures using only within-system data, including services completed elsewhere in the numerator improved performance pneumococcal vaccine (73% vs 82%); breast (69% vs 75%), colorectal (58% vs 70%), and cervical cancer (53% vs 62%); and osteoporosis (72% vs 75%) screening ( P < .05). Visit-based CDS can capture clinician-reported preventive services, and accounting for services completed elsewhere improves performance on quality measures.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Serviços Preventivos de Saúde
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Indicadores de Qualidade em Assistência à Saúde
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Sistemas de Apoio a Decisões Clínicas
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Registros Eletrônicos de Saúde
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Melhoria de Qualidade
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Screening_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article