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临床医生仪表板视图与预防保健结果测量指标的改进:回顾性分析。

Clinician dashboard views and improvement in preventative health outcome measures: a retrospective analysis.

机构信息

Department of Medicine, Case Western Reserve University, MetroHealth System, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.

Center for Health Care Research and Policy, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.

出版信息

BMC Health Serv Res. 2019 Jul 11;19(1):475. doi: 10.1186/s12913-019-4327-3.

Abstract

BACKGROUND

Measuring and reporting outcome data is fundamental for health care systems to drive improvement. Our electronic health record built a dashboard that allows each primary care provider (PCP) to view real-time population health quality data of their patient panel and use that information to identify care gaps. We hypothesized that the number of dashboard views would be positively associated with clinical quality improvement.

METHODS

We performed a retrospective analysis of change in quality scores compared to number of dashboard views for each PCP over a five-month period (2017-18). Using the manager dashboard, we recorded the number of views for each provider. The quality scores analyzed were: colorectal cancer (CRC) screening rates and diabetic patients with an A1c greater than 9% or no A1c in the past year.

RESULTS

Data from 120 PCPs were included. The number of dashboard views by each PCP ranged from 0 to 222. Thirty-one PCPs (25.8%) did not view their dashboard. We found no significant correlation between views and change in quality scores (correlation coefficient = 0.06, 95% CI [- 0.13, 0.25] and - 0.05, 95% CI [- 0.25, 0.14] for CRC and diabetes, respectively).

CONCLUSION

Clinical dashboards provide feedback to PCPs and are likely to become more available as healthcare systems continue to focus on improving population health. However, dashboards on their own may not be sufficient to impact clinical quality improvement. Dashboard viewership did not appear to impact clinician performance on quality metrics.

摘要

背景

衡量和报告结果数据对于医疗保健系统推动改进至关重要。我们的电子健康记录构建了一个仪表板,允许每位初级保健提供者(PCP)查看其患者群体的实时人口健康质量数据,并利用这些信息来识别护理差距。我们假设仪表板的查看次数与临床质量改进呈正相关。

方法

我们对每位 PCP 在五个月期间(2017-18 年)的质量评分变化与仪表板查看次数进行了回顾性分析。使用经理仪表板,我们记录了每位提供者的查看次数。分析的质量评分包括:结直肠癌(CRC)筛查率和过去一年中 A1c 大于 9%或没有 A1c 的糖尿病患者。

结果

纳入了 120 名 PCP 的数据。每位 PCP 的仪表板查看次数从 0 到 222 不等。有 31 名 PCP(25.8%)没有查看他们的仪表板。我们没有发现查看次数与质量评分变化之间存在显著相关性(相关性系数分别为 0.06,95%CI [-0.13, 0.25] 和 -0.05,95%CI [-0.25, 0.14],用于 CRC 和糖尿病)。

结论

临床仪表板为 PCP 提供反馈,并且随着医疗保健系统继续专注于改善人口健康,它们可能会变得更加普及。然而,仅仪表板本身可能不足以影响临床质量改进。仪表板的查看次数似乎并未影响临床医生在质量指标上的表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bc/6621998/f04f4d5309f3/12913_2019_4327_Fig1_HTML.jpg

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