Example of how CDS alerts are presented to a clinician for review.
Bringing Measurement to the Point of Care
Project Final Report (PDF, 345.54 KB) Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
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Project Details -
Completed
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Grant NumberR18 HS017059
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AHRQ Funded Amount$694,961
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Principal Investigator(s)
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Organization
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LocationNew York CityNew York
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Project Dates09/30/2007 - 09/29/2010
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Care Setting
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Type of Care
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Health Care Theme
This project assessed the impact and challenges of introducing health information technology tools to assist small primary care practices in measuring quality of care. In collaboration with an electronic health record (EHR) vendor, the Primary Care Information Project (PCIP) deployed new functionality that allowed clinicians to view 'real time' measures of the delivery of clinical preventive services. In addition, the EHR added patient specific alerts and 'one click' options to act on potentially missed opportunities for followup care or recommended preventive services. Providers using these systems were given substantial technical support and training to use these tools.
The primary objectives of this project were to:
- Design a simple and intuitive point of care quality measurement and decision support user interface.
- Validate a set of automated clinical quality measures that address priority public health issues.
- Characterize provider attitudes and measure provider satisfaction with performance indicators.
- Determine the impact of the quality dashboard on the accuracy of, and provider satisfaction with, EHR derived quality measures.
- Disseminate findings though national measurement consensus organizations (e.g., National Quality Forum's "Standardizing Ambulatory Care Performance Measures" project), through EHR vendors participating in this project, and through peer reviewed publications.
The study found that across the 56 practices involved, most did not have prior quality measurement experience or engage in quality improvement activities prior to the adoption of the EHR. Though most quality measures selected for this study showed post implementation improvement, a review of over 6,100 patient records showed that automated EHR-derived quality reports underreported many of the practices' performance. Providers found some documentation tasks within the EHR to be straight forward, while other data entry processes posed challenges that affect subsequent quality measurement and reporting.
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Citation:
Ryan AM, McCullough CM, Shih SC, et al. The intended and unintended consequences of quality improvement interventions for small practices in a community-based electronic health record implementation project. Med Care 2014 Sep;52(9):826-32. PMID: 25100231.
Principal Investigator:
Wu, Winfred
Project Name:
Bringing Measurement to the Point of Care
Document Type:
Journal Publication
Research Method:
Quantitative, Randomized Controlled Trial (RCT)
Population:
Physician
Citation:
Wang JJ, Sebek KM, McCullough CM, et al. Sustained improvement in clinical preventive service delivery among independent primary care practices after implementing electronic health record systems. Prev Chronic Dis 2013 Aug 1;10:E130.
Principal Investigator:
Wu, Winfred
Project Name:
Bringing Measurement to the Point of Care
Document Type:
Journal Publication
Research Method:
Time Series
Citation:
Parsons A, McCullough C, Wang J, et al. Validity of electronic health record-derived quality measurement for performance monitoring. J Am Med Inform Assoc 2012 July; 19(4): 604-9.
Principal Investigator:
Wu, Winfred
Project Name:
Bringing Measurement to the Point of Care
Document Type:
Journal Publication
Citation:
Wu, W. Bringing Quality Measurement to the Point of Care - Final Report. (Prepared by New York City Department of Health and Mental Hygiene under Grant No. R18 HS017059). Rockville, MD: Agency for Healthcare Research and Quality, 2011.
Link:
PDF (345.54 KB)
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
Principal Investigator:
Wu, Winfred
Project Name:
Bringing Measurement to the Point of Care
Document Type:
Report
Population:
Minority Populations
Citation:
Diamond CC, Mostashari F, Shirky C. Collecting and sharing data for population health: a new paradigm. Health Aff (Millwood) 2009 Mar-Apr;28(2):454-66.
Principal Investigator:
Wu, Winfred
Project Name:
Bringing Measurement to the Point of Care
Document Type:
Journal Publication, Editorial
Citation:
Frieden TR, Mostashari F. Health care as if health mattered. JAMA 2008 Feb 27;299(8):950-2.
Principal Investigator:
Wu, Winfred
Project Name:
Bringing Measurement to the Point of Care
Document Type:
Journal Publication, Editorial
Disclaimer
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Description:
Document that provides a core measures crosswalk across the study's measures and those of national entities, such as the AQA.
Project Name:
Bringing Measurement to the Point of Care
Disclaimer
Disclaimer details
Description:
This is an interview guide designed to be conducted with physicians in an ambulatory setting. The tool includes questions to assess attitudes of users of electronic health records.
Document Type:
Interview Guide
Research Method:
Attitude Assessment
Population:
Physician
Care Setting:
Ambulatory Setting
Copyright Status:
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
Organization:
New York City Department of Health and Mental Hygiene
Location:
New York City, New York
Project Name:
Bringing Measurement to the Point of Care
Description:
This is a questionnaire designed to be completed by patients in an ambulatory setting. The tool includes questions to assess user's perceptions of electronic health records.
Document Type:
Questionnaire/Survey
Research Method:
Attitude Assessment
Population:
Patient
Care Setting:
Ambulatory Setting
Copyright Status:
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
Organization:
New York City Department of Health and Mental Hygiene
Location:
New York City, New York
Project Name:
Bringing Measurement to the Point of Care
Description:
This is a questionnaire designed to be completed by physicians in an ambulatory setting. The tool includes questions to assess user's perceptions of electronic health records.
Document Type:
Questionnaire/Survey
Research Method:
Attitude Assessment
Population:
Physician
Care Setting:
Ambulatory Setting
Copyright Status:
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
Organization:
New York City Department of Health and Mental Hygiene
Location:
New York City, New York
Project Name:
Bringing Measurement to the Point of Care
Description:
This is a questionnaire designed to be completed by physicians in an ambulatory setting. The tool includes questions to assess user's satisfaction of electronic health records.
Document Type:
Questionnaire/Survey
Research Method:
Attitude Assessment
Population:
Physician
Care Setting:
Ambulatory Setting
Copyright Status:
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
Organization:
New York City Department of Health and Mental Hygiene
Location:
New York City, New York
Project Name:
Bringing Measurement to the Point of Care
Description:
This is a questionnaire designed to be completed by nurses and physicians in an ambulatory setting. The tool includes questions to assess user's perceptions of electronic health records.
Document Type:
Questionnaire/Survey
Research Method:
Attitude Assessment
Care Setting:
Ambulatory Setting
Copyright Status:
Permission has been obtained from the survey developers for unrestricted use of this survey; it may be modified or used as is without additional permission from the authors.
Organization:
New York City Department of Health and Mental Hygiene
Location:
New York City, New York
Project Name:
Bringing Measurement to the Point of Care
Disclaimer
Disclaimer details
Citation:
Samarth A, Grant E. Using Health Information Technology to Perform Medication Reconciliation: Findings from the AHRQ Health IT Portfolio. (Prepared by the AHRQ National Resource Center for Health Information Technology under Contract No. 290-04-0016.) AHRQ Publication No. 10-0051-EF. Rockville, MD: Agency for Healthcare Research and Quality. February 2010.
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