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医疗保险电子健康记录激励计划:核心和菜单指标的提供者表现。

The Medicare Electronic Health Record Incentive Program: provider performance on core and menu measures.

机构信息

Division of General Internal Medicine, Brigham & Women's Hospital, Boston, MA; Partners HealthCare, Boston, MA; Harvard Medical School, Boston, MA.

出版信息

Health Serv Res. 2014 Feb;49(1 Pt 2):325-46. doi: 10.1111/1475-6773.12134. Epub 2013 Dec 21.

Abstract

OBJECTIVE

To measure performance by eligible health care providers on CMS's meaningful use measures.

DATA SOURCE

Medicare Electronic Health Record Incentive Program Eligible Professionals Public Use File (PUF), which contains data on meaningful use attestations by 237,267 eligible providers through May 31, 2013.

STUDY DESIGN

Cross-sectional analysis of the 15 core and 10 menu measures pertaining to use of EHR functions reported in the PUF.

PRINCIPAL FINDINGS

Providers in the dataset performed strongly on all core measures, with the most frequent response for each of the 15 measures being 90-100 percent compliance, even when the threshold for a particular measure was lower (e.g., 30 percent). PCPs had higher scores than specialists for computerized order entry, maintaining an active medication list, and documenting vital signs, while specialists had higher scores for maintaining a problem list, recording patient demographics and smoking status, and for providing patients with an after-visit summary. In fact, 90.2 percent of eligible providers claimed at least one exclusion, and half claimed two or more.

CONCLUSIONS

Providers are successfully attesting to CMS's requirements, and often exceeding the thresholds required by CMS; however, some troubling patterns in exclusions are present. CMS should raise program requirements in future years.

摘要

目的

衡量符合条件的医疗保健提供者在 CMS 的有意义使用措施方面的表现。

数据来源

医疗保险电子健康记录激励计划合格专业人员公共使用文件(PUF),其中包含截至 2013 年 5 月 31 日,237,267 名合格提供者在有意义的使用认证方面的数据。

研究设计

对 PUF 中报告的 15 项核心和 10 项菜单措施中与电子病历功能使用相关的横截面分析。

主要发现

数据集中的提供者在所有核心措施上表现出色,在 15 项措施中的每一项中,最常见的反应都是 90-100%的合规性,即使特定措施的阈值较低(例如 30%)。初级保健医生在计算机化医嘱录入、维护活动药物清单和记录生命体征方面的得分高于专家,而专家在维护问题清单、记录患者人口统计学和吸烟状况以及为患者提供就诊后总结方面的得分更高。事实上,90.2%的合格提供者声称至少有一个排除项,其中一半声称有两个或更多。

结论

提供者正在成功地证明 CMS 的要求,并且经常超过 CMS 要求的阈值;然而,存在一些令人不安的排除模式。CMS 应在未来几年提高计划要求。

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