Automated Quality Reporting Through EHRs Can Result in Significant Efficiencies and Care Improvements

Using electronic health records to automate reporting of quality measures reduces reporting time required for one measure set alone by about 50 percent, according to a new study published in the Journal of the American Medical Informatics Association.

According the a release issued by Kaiser Permanent, for the six measures studied in this paper, we were able to extract between 43 percent and 100 percent of the elements needed for the measures.

“With an increased focus on transparency in the healthcare industry, we are seeing significant growth in the number of public reporting initiatives, and automated quality reporting allows us to keep up with these initiatives without adding to high overhead costs.” said Jed Weissberg, MD, senior vice president of Hospitals, Quality and Care Delivery Excellence, Kaiser Permanente. “An added benefit of automated reporting of quality measures is that some data become available real-time, further enabling us to improve care in an expedited manner.”

Kaiser Permanente has fully or partly automated reporting for six Total Joint Commission measure sets (acute myocardial infarction, emergency department patient flow, immunizations, the surgical care improvement project, pneumonia and VTE prophylaxis) and time savings resulting from automation were substantial.

According to the release, if the observed 50 percent reduction in reporting time for just one measure (the surgical care improvement project) is any indication of potential efficiencies, time savings are likely achievable on a broad scale. Overhead costs of public quality reporting are significant. For example, Kaiser Permanente consistently reports on 50 well-established metrics. In addition to improved efficiencies, automated quality reporting allows for immediate access to data, which can more quickly lead to improved care for patients.

“It is great to see an organization put effort into creating a faster and more efficient reporting system for its core measure sets by utilizing the substantial benefits of an electronic health record,” said Jerod M. Loeb, Ph.D., executive vice president, Healthcare Quality Evaluation, The Joint Commission. “Most of the measures in our core measure sets have been designated as accountability measures by The Joint Commission, which require hospitals to implement care processes that have been directly tied to better patient outcomes, such as providing aspirin to heart attack patients within 24 hours of arrival in the hospital. We believe that our accountability measures are an important component in improving a hospital’s patient care.”

The study also acknowledges the gap between the current and desired states of automated quality reporting. The primary function of electronic health record systems is to capture, store and track clinical data to support care delivery; they were not initially designed to calculate, compile and report on quality measures. As a result, a great deal of the quality reporting supported by EHRs is not fully automated.

“Many electronic health record systems require care providers to enter additional data and provide documentation that may slow down the care process,” said Terhilda Garrido, vice president of Health IT Transformation and Analytics, Kaiser Permanente. “The trick is to make use of the ‘natural digital exhaust’ from existing clinical processes, which can also increase the credibility and accuracy of the data.”

Kaiser Permanente has been recognized for its leadership in harnessing health IT to improve quality and care delivery. Kaiser Permanente HealthConnect, the healthcare organization’s electronic health record, is one of the most robust and sophisticated in the nation. KP HealthConnect enables all of Kaiser Permanente clinicians to electronically access their patients’ Kaiser Permanente medical records and serves as a model for other care systems.

KP HealthConnect gives providers an important tool to improve the quality of the care and service delivered to members and patients. It helps ensure patient safety and quality care by providing access to comprehensive patient information by supporting care team coordination and communication and by including the latest best practice research in one place.

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