Kittelson Sheri, Pierce Read, Youngwerth Jeanie
1 Division of Hospital Medicine, Department of Medicine, University of Florida , Gainesville, Florida.
2 Department of Medicine, Institute for Healthcare Quality, Safety, and Efficiency, Hospital Medicine Group, University of Colorado School of Medicine , Aurora, Colorado.
J Palliat Med. 2017 May;20(5):517-527. doi: 10.1089/jpm.2016.0292. Epub 2017 Jan 12.
In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public.
Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard.
The scorecard was organized into a format of quality measures identified by the Measuring What Matters (MWM) project that are defined as important to the team, automatically extracted from the electronic health record, valid, and can be impacted over time.
The scorecard was initially created using University of Florida Health (UF) data, a new PC program, and successfully applied and implemented at University of Colorado Anschutz Medical Campus (CU), a second institution with a mature PC program.
Clinical metrics are organized in the scorecard based on MWM and described in terms of the metric definition, rationale for selection, measure type (structure, process, or outcome), and whether this represents a direct or proxy measure.
RESULTS/CONCLUSIONS: The process of constructing the scorecard helped identify areas within both systems for potential improvement in team structure, clinical processes, and outcomes. In addition, by automating data extraction, the scorecard decreases costs associated with manual data entry and extraction, freeing clinical staff to care for patients and increasing the value of PC delivered to patients.
为应对医疗质量差和成本上升的问题，医疗改革的三重目标对医疗服务提供者向支付方、合作伙伴和公众证明价值的要求有所提高。
随着时间的推移，通过电子方式自动衡量姑息治疗（PC）项目对临床、运营和财务系统的有意义影响，对于该领域的成功以及开发此自动化PC记分卡的目标至关重要。
记分卡采用了“衡量重要事项”（MWM）项目确定的质量衡量指标格式，这些指标被定义为对团队很重要，可从电子健康记录中自动提取，有效且会随时间产生影响。
记分卡最初是使用佛罗里达大学健康中心（UF）的数据创建的，这是一个新的PC项目，并在科罗拉多大学安舒茨医学校区（CU）成功应用和实施，CU是一个拥有成熟PC项目的第二个机构。
临床指标在记分卡中根据MWM进行组织，并根据指标定义、选择理由、测量类型（结构、过程或结果）以及这是直接测量还是代理测量进行描述。
结果/结论：构建记分卡的过程有助于确定两个系统中在团队结构、临床过程和结果方面有潜在改进空间的领域。此外，通过自动提取数据，记分卡降低了与手动数据录入和提取相关的成本，使临床工作人员能够腾出时间照顾患者，并提高了提供给患者的PC的价值。
