Ahmad Faraz S, Rasmussen Luke V, Persell Stephen D, Richardson Joshua E, Liss David T, Kenly Pauline, Chung Isabel, French Dustin D, Walunas Theresa L, Schriever Andy, Kho Abel N
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
The Center for Health Information Partnerships (CHiP), Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
JAMIA Open. 2019 Sep 20;2(4):423-428. doi: 10.1093/jamiaopen/ooz038. eCollection 2019 Dec.
Third-party platforms have emerged to support small primary care practices for calculating and reporting electronic clinical quality measures (eCQM) for federal programs like The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Payment System (MIPS). Yet little is known about the capabilities and limitations of electronic health record systems (EHRs) to enable data access for these programs. We connected 116 small- to medium-sized practices with seven different EHRs to popHealth, an open-source eCQM platform. We identified the prevalence of following problems with eCQM data for data extraction in seven different EHRs: (1) Lack of coded data in five of seven; (2) Incorrectly categorized data in four of seven; (3) Isosemantic data (data within the incorrect context) in four of seven; (4) Coding that could not be directly evaluated in six of seven; (5) Errors in date assignment and labeled as historical values in five of seven; and (6) Inadequate data to assign the correct code in two of seven. We recommend specific enhancements to EHR systems that can promote effective eCQM implementation and reporting to MACRA and MIPS.
第三方平台已出现，以支持小型基层医疗实践机构计算和报告电子临床质量指标（eCQM），用于诸如2015年《医疗保险准入与儿童健康保险计划再授权法案》（MACRA）和基于绩效的激励支付系统（MIPS）等联邦项目。然而，对于电子健康记录系统（EHR）为这些项目提供数据访问的能力和局限性，人们知之甚少。我们将116家中小型医疗机构与七个不同的电子健康记录系统连接到popHealth，这是一个开源的eCQM平台。我们确定了七个不同电子健康记录系统中在提取eCQM数据时出现以下问题的普遍程度：（1）七个中有五个缺乏编码数据；（2）七个中有四个数据分类错误；（3）七个中有四个等语义数据（处于错误背景下的数据）；（4）七个中有六个编码无法直接评估；（5）七个中有五个日期分配错误并被标记为历史值；以及（6）七个中有两个数据不足以分配正确的代码。我们建议对电子健康记录系统进行具体改进，以促进有效地实施eCQM并向MACRA和MIPS报告。
