RT Journal Article
SR Electronic
T1 Clinical Quality Measure Exchange is Not Easy
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 207
OP 211
DO 10.1370/afm.2649
VO 19
IS 3
A1 Robert L. Phillips
A1 Lars Peterson
A1 Ted E. Palen
A1 Scott A. Fields
A1 Michael L. Parchman
A1 John Johannides
YR 2021
UL http://www.annfammed.org/content/19/3/207.abstract
AB PURPOSE The Trial of Aggregate Data Exchange for Maintenance of Certification and Raising Quality was a randomized controlled trial which first had to test whether quality reporting could be a by-product of clinical care. We report on the initial descriptive study of the capacity for and quality of exchange of whole-panel, standardized quality measures from health systems.METHODS Family physicians were recruited from 4 health systems with mature quality measurement programs and agreed to submit standardized, physician-level quality measures for consenting physicians. Identified measure or transfer errors were captured and evaluated for root-cause problems.RESULTS The health systems varied considerably by patient demographics and payer mix. From the 4 systems, 256 family physicians elected to participate. Of 19 measures negotiated for use, 5 were used by all systems. There were more than 15 types of identified errors including breaks in data delivery, changes in measures, and nonsensical measure results. Only 1 system had no identified errors.CONCLUSIONS The secure transfer of standardized, physician-level quality measures from 4 health systems with mature measure processes proved difficult. There were many errors that required human intervention and manual repair, precluding full automation. This study reconfirms an important problem, namely, that despite widespread health information technology adoption and federal meaningful use policies, we remain far from goals to make clinical quality reporting a reliable by-product of care.