Composite quality of care scores, electronic health record maturity models, and their associations; preliminary literature review results.

To accurately assess the association between the use of EHR systems and the quality of healthcare we need (composite) measures for quality of healthcare, and a model to measure the maturity of the EHR. This Medline-based literature study therefore focussed on three topics; (1) methods to compose a measure for quality of care based on individual quality indicators (QI), (2) models to measure EHR maturity, and (3) the association between the former two. Composite quality is most often measured using opportunity-based scores, maturity is measured in functionalities or levels. EHR maturity measures are not used extensively in biomedical literature. Most studies found a positive association between EHR use and the quality of care but almost none of them differentiate in maturity of EHR which hampers firm conclusions about this relation.