April 1, 2009Medical Care
Improving Hypertension Quality Measurement Using Electronic Health Records
Key result
Applying sophisticated EHR-based quality measures increased the measured rate of adequate hypertension care from 58.1% to 80.5% in nondiabetics, and from 29.9% to 73.6% in diabetics.
Why the study?
Does using sophisticated EHR-based measures improve the assessment of hypertension care quality compared to simple outcome measures in hypertensive adults?
Population
5905 hypertensive adults with 3 or more clinic visits between July 1, 2005 and December 31, 2006 at an…
Comparison
Sophisticated hypertension quality measures… vs Simple outcome measures
Design
Cross-sectional
Authors
Discussion
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Implication
May support nuanced EHR hypertension metrics to avoid penalizing resistant cases; leaves open prospective outcome validation before changing assessments.
Study Design
Type
Cross-Sectional (n=5,905)
Multicenter
No
Structured PICO
Does using sophisticated EHR-based measures improve the assessment of hypertension care quality compared to simple outcome measures in hypertensive adults?
P
Population
5905 hypertensive adults with 3 or more clinic visits between July 1, 2005 and December 31, 2006 at an internal medicine clinic
I
Intervention
Sophisticated hypertension quality measures utilizing electronic health record data (accounting for mean blood pressure, aggressive treatment, low diastolic blood pressure, and undiagnosed hypertension)
C
Comparator
Simple outcome measures (proportion of diagnosed hypertension patients with last blood pressure below goal: <140/90 mm Hg or <130/80 if diabetic)
O
Outcome
Measured quality of hypertension care (proportion of patients considered to have adequate care)
Sophisticated EHR-based hypertension measures provide a more nuanced and potentially more accurate assessment of care quality than simple last-blood-pressure metrics, avoiding penalization for treating resistant hypertension.
Cite This Study
Persell et al. (2009) conducted a cross-sectional in Hypertension (n=5,905). Complex EHR-based hypertension quality measures vs. Simple outcome measures (last blood pressure below goal) was evaluated on Proportion of patients classified as having adequate hypertension care. Applying sophisticated EHR-based quality measures increased the measured rate of adequate hypertension care from 58.1% to 80.5% in nondiabetics, and from 29.9% to 73.6% in diabetics.