Electronic health records can help providers document their performance. But they're only as good as their users--and plenty of providers are abdicating their responsibility to add information to their EHRs that can't be done automatically, adversely affecting their performance measures.
That's the cautionary tale from a recent study published in the Journal of the American Medical Informatics Association, which found that workflow and documentation habits have a "profound" negative impact on quality measures. Accurately capturing quality measures not only affects the quality of patient care; it also can influence the amount of revenue the provider receives under pay for performance and other programs.
Researchers found that providers were overlooking chronic conditions/diseases located elsewhere in the patients' chart, such as obesity and smoking. They also were not bothering to add in lab data, tests, and procedure results, which often has to be done manually. The study additionally uncovered that there were design flaws in the structure of the EHRs being used, such as lack of options to document data in certain fields, which negatively impacted the quality measures.
The study focused on 82 New York physician practices, reviewing 4,081 EHR charts. The average practice missed 50 percent of the eligible patients for three out of eleven quality measures--smoking cessation intervention and cholesterol control. The practices also underreported six of the 11 measures, including breast center screening.
The researchers recommended that providers need "regular prompts, training and feedback to alter their documentation habits." They also suggested that providers use claims data to populate their EHRs and clinical decision support.
To learn more:
- read the study abstract