The unprecedented level of detail in EMR clinical data opens new possibilities for defining clinical quality measures in more clinically meaningful ways. However, more detailed data can cause difficulties in ensuring that data across institutions are comparable, according to an article in the online March edition of the Journal of Medical Informatics Association.
Michael G. Kahn, MD, department of pediatrics at the University of Colorado in Denver and Daksha Ranade from the department of clinical informatics at The Children’s Hospital in Aurora, Colo., sought to examine the impact of billing and clinical data extracted from an EMR system on the calculation of an adverse drug event (ADE) quality measure approved for use in The Joint Commission’s ORYX program, a mandatory national hospital quality reporting system.
The Child Health Corporation of America‘s (CHCA) “Use of Rescue Agents—ADE Trigger” quality measure uses medication billing data from 48 nonprofit free-standing children’s hospitals in the U.S. contained in the Pediatric Health Information Systems (PHIS) data warehouse and was used to create The Joint Commission-approved quality measure, according to the authors.
“Using a similar query, we calculated the quality measure using PHIS plus four data sources extracted from our EMR system:…Four versions of the ‘Use of Rescue Agent – ADE Trigger’ quality measure’s numerator and denominator events were developed as SQL-based queries against the EPIC EMR system: