EHRs shifting quality measurement methods

Electronic quality measures--based on data found in electronic health records--will become the norm in the not-too-distant future, replacing currently used paper charts, consumer surveys and computerized insurance claims to measure quality care, according to a new article published in the International Journal for Quality in Health Care.

Researchers premised that the adoption of EHRs and related health IT creates new ways of thinking about measuring quality care, considering the unique functions and capabilities of EHRs.

"Quality performance measures and mindsets remain heavily anchored to constructs and contexts previously applied using paper charts and administrative records," the authors wrote. "As health-care delivery systems become digital, so too must the infrastructure we use to measure the performance of these systems."

Five evolving electronic quality measurement (e-QM) categories were identified, including:

  • Translated e-QMs from traditional quality measures, and not EHR supported measurement sets, such as those from the National Committee of Quality Assurance
  • HIT-assisted e-QMs, which make use of an EHR's ability to capture and integrate medical information but don't take full advantage of an EHR's capability, such as results of lab tests
  • HIT-enabled e-QMs, which would not be possible outside of health IT, such as the time-stamp capability within an EHR
  • HIT system management e-QMs, such as EHR item completion rates
  • e-iatrogenesis e-QMs, which document patient harm caused at least in part by health IT.

The authors also pointed out that e-QMs will change quality measurement in other ways, such as more real time review of quality and the importance of EHR workflow in affecting the quality of care provided.  

Improving the quality of patient care is a major component in the adoption of EHRs and the attainment of Meaningful Use in the EHR incentive program, as well as other patient care initiatives, such as medical homes, pay-for-performance programs and the Medicare Shared Savings Program.

To learn more:
- read the International Journal for Quality in Health Care article
- here are the proposed quality measures for Stage 2 of Meaningful Use
- check out the measures for ACOs
- read about medical home quality measures