Feasibility of EHRs to measure adolescent care quality 'remains unfulfilled'

It currently is not very feasible to use electronic health records to measure quality in adolescent well care, according to a study published in the Journal for Healthcare Quality.

For the study, researchers from the National Committee for Quality Assurance and elsewhere wanted to determine if and how well EHRs could be used for quality measurement in adolescent treatment. Pediatric/adolescent patients have unique needs, which limits the standardization of terms and structured fields needed for an EHR to harness the detailed data for quality measurement.  

IT professionals in 10 institutions that provide primary care services to adolescents were surveyed on immunizations, screenings for conditions such as depression, collection of data on sexual activity and risk-behavior counseling, such as sleep and diet. The researchers found that quality measures for adolescents lagged behind those for adults in the number of measures and scope of health concerns addressed.

They also found a "wide range of feasibility" of using EHRs at all sites, and that the current EHR-based quality measurements for many adolescent care measures were not yet "ready for prime time." As a result, the feasibility of using EHRs for this function "remains unfulfilled." For instance, adolescent care involves a lot of preventive counseling and guidance, both of which are poorly captured in traditional claims-based quality measures.

"[I]t is clear that at least for adolescent well care, large pediatric institutions are developing the capacity to report on quality measurement from health records," the authors said. "Refinement of measures, standardization of reporting fields, incentives for systems and clinicians for documentation of required quality data elements, and evaluating completeness of records will all be important next steps."

To learn more:
- read the full study