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The Challenge of Measuring Quality of Care From the Electronic Health Record

RAND Health, Santa Monica, California, roth{at}rand.org

Yee-Wei Lim, MD, PhD

RAND Health, Santa Monica, California

Joshua M. Pevnick, MD

RAND Health, Santa Monica, and in the Division of General Internal Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California

Steven M. Asch, MD, MPH

RAND Health, Santa Monica; VA Greater Los Angeles Healthcare System; and the Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California

Elizabeth A. McGlynn, PhD

RAND Health, Santa Monica, California

The electronic health record (EHR) is seen by many as an ideal vehicle for measuring quality of health care and monitoring ongoing provider performance. It is anticipated that the availability of EHR-extracted data will allow quality assessment without the expensive and time-consuming process of medical record abstraction. A review of the data requirements for the indicators in the Quality Assessment Tools system suggests that only about a third of the indicators would be readily accessible from EHR data. Other factors involving complexity of required data elements, provider documentation habits, and EHR variability make the task of quality measurement more difficult than may be appreciated. Accurately identifying eligible cases for quality assessment and validly scoring those cases with EHR-extracted data will pose significant challenges but could potentially plummet the cost and therefore expand the use of quality assessment.

Key Words: electronic health record • quality of care • quality improvement

This version was published on September 1, 2009

American Journal of Medical Quality, Vol. 24, No. 5, 385-394 (2009)
DOI: 10.1177/1062860609336627


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