The Article in Brief
Clinical Quality Measure Exchange Is Not Easy
Robert L. Phillips, Jr , and colleagues
Background Family physicians provide nearly 20% of all clinical outpatient visits, translating
to 200 million visits in the U.S. annually, according to the Centers for Disease Control
and Prevention. Frontline clinicians continue to report failures of certified electronic
health records (EHRs) to meet federal certification requirements and electronic reporting
needs.
What This Study Found Researchers created the Trial of Aggregate Data Exchange for Maintenance of certification
and Raising Quality, a randomized controlled trial, to assess whether quality measure
reporting could be made a byproduct of clinical care and quality improvement. They
recruited family physicians from four health systems. A total of 256 family physicians
participated. Of 19 measures negotiated for use, five were used by all systems. The
researchers identified 15 types of errors, including breaks in data delivery; changes
in measures; and nonsensical measure results. Only one system had no identified errors.
The study concluded that the secure transfer of standardized, physician-level quality
measures from the four health systems, despite their having mature processes in place,
proved difficult. There were many errors that required human intervention and manual
repair, which precluded full automation.
Implications
- The study reconfirms that despite widespread health information technology adoption
and federally meaningful use policies, health care remains far from reaching its goals
of making clinical quality reporting a reliable byproduct of care.