Tonner Chris, Schmajuk Gabriela, Yazdany Jinoos
aDepartment of Medicine, Division of Rheumatology, University of California, San Francisco bDivision of Rheumatology, Veterans Affairs Medical Center, San Francisco, California, USA.
Curr Opin Rheumatol. 2017 Mar;29(2):131-137. doi: 10.1097/BOR.0000000000000364.
This article reviews the evolution of quality measurement in rheumatology, highlighting new health-information technology infrastructure and standards that are enabling unprecedented innovation in this field.
Spurred by landmark legislation that ties physician payment to value, the widespread use of electronic health records, and standards such as the Quality Data Model, quality measurement in rheumatology is rapidly evolving. Rather than relying on retrospective assessments of care gathered through administrative claims or manual chart abstraction, new electronic clinical quality measures (eCQMs) allow automated data capture from electronic health records. At the same time, qualified clinical data registries, like the American College of Rheumatology's Rheumatology Informatics System for Effectiveness registry, are enabling large-scale implementation of eCQMs across national electronic health record networks with real-time performance feedback to clinicians. Although successful examples of eCQM development and implementation in rheumatology and other fields exist, there also remain challenges, such as lack of health system data interoperability and problems with measure accuracy.
Quality measurement and improvement is increasingly an essential component of rheumatology practice. Advances in health information technology are likely to continue to make implementation of eCQMs easier and measurement more clinically meaningful and accurate in coming years.
本文回顾了风湿病学质量测量的发展历程,重点介绍了新的健康信息技术基础设施和标准,这些正推动该领域实现前所未有的创新。
在将医生薪酬与医疗价值挂钩的里程碑式立法、电子健康记录的广泛使用以及诸如质量数据模型等标准的推动下,风湿病学的质量测量正在迅速发展。新的电子临床质量指标(eCQMs)不再依赖通过行政索赔或人工病历摘要收集的护理回顾性评估,而是允许从电子健康记录中自动获取数据。与此同时,合格的临床数据登记处,如美国风湿病学会的风湿病疗效信息系统登记处,正在全国电子健康记录网络中大规模实施eCQMs,并为临床医生提供实时绩效反馈。尽管在风湿病学和其他领域存在eCQM开发和实施的成功案例,但仍存在挑战,如卫生系统数据缺乏互操作性以及测量准确性问题。
质量测量与改进日益成为风湿病学实践的重要组成部分。未来几年,健康信息技术的进步可能会继续使eCQMs的实施更加容易,测量在临床上更具意义和准确性。