ArticleApplied clinical informatics2014
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
Article in Applied clinical informatics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The use of Electronic Health Records to Support Population Health: A Systematic Review of the Literature.Journal of medical systems · 2018Pooled it
- Assessing Data Adequacy for High Blood Pressure Clinical Decision Support: A Quantitative Analysis.Applied clinical informatics · 2021Article
- 2017 National Standards for Diabetes Self-Management Education and Support.Diabetes spectrum : a publication of the American Diabetes Association · 2017Article
- Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data*. An Agile Framework.Methods of information in medicine · 2017Article
- Utility of an Electronic Health Record Report to Identify Patients with Delays in Testing for Poorly Controlled Diabetes.Joint Commission journal on quality and patient safetyArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundIn this new era after the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the literature on lessons learned with electronic health record (EHR) implementation needs to be revisited.
objectivesOur objective was to describe what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics, specifically feasibility of data retrieval, measurements over time, quality of data, and how our teams used this data.
methodsA cross-sectional study was conducted from October 2008 to October 2012 in four safety-net clinics located in the Midwest and Western United States. A data warehouse that stores data from across the U.S was utilized for data extraction from patients with diabetes or hypertension diagnoses and at least two office visits per year. Standard quality measures were collected over a period of two to four years. All sites were engaged in a partnership model with the IT staff and a shared learning process to enhance the use of the quality metrics.
resultsWhile use of the algorithms was feasible across sites, challenges occurred when attempting to use the query results for research purposes. There was wide variation of both process and outcome results by individual centers. Composite calculations balanced out the differences seen in the individual measures. Despite using consistent quality definitions, the differences across centers had an impact on numerators and denominators. All sites agreed to a partnership model of EHR implementation, and each center utilized the available resources of the partnership for Center-specific quality initiatives.
conclusionsUtilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care delivery models.
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Registered trials
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