Advances in research, standards, more

This month’s news includes coverage from the annual American Health Information Management Association (AHIMA) convention, a substantial grant aimed at reducing medical errors associated with EHRs and new studies pointing out the benefits and flaws of current EHR systems.

The Agency for Healthcare Research and Quality has awarded Oregon Health & Science (OHSU) University in Portland a $1 million grant. “Most tools used in medicine require knowledge and skills of both those who develop them and use them,” said William R. Hersh, MD, chair of the department of medical informatics and clinical epidemiology. “Even tools that are themselves innocuous could be detrimental to patient care if used improperly.”

OHSU informatics researchers will use the grant money to develop simulations that test clinicians’ abilities to recognize errors presented in EHRs.

In one of the first studies to find a positive correlation between quality of ambulatory care provided and EHR utilization, physicians using EHRs performed better than their paper-based peers on quality of care for four screening measures for diabetes, breast cancer, chlamydia and colorectal cancer, according to a study published in the Journal of General Internal Medicine.

Among EHR users, 90 percent met the quality measure for HbA1c testing in diabetics compared to 84 percent of paper-based providers, 89 percent met the measure for breast cancer screening compared to 74 percent, 66 percent met the measure for chlamydia screening compared to 53 percent and 51 percent met the measure for colorectal cancer screening.

This year’s annual conference of the AHIMA was held in Chicago and included several topics associated with EHRs, including Meaningful Use.

In one session, speakers called for standardization of standards to achieve greater interoperability. The common Meaningful Use dataset has 16 elements that should be recorded as structured data and used in the transmission of data and summaries of care. There are limitations and variations between each of the standard terminologies—they apply terms differently, for example. "Compliance can be quite intensive as a result," said Amy Sheide, RN, 3M Health information services.

No single term covers all healthcare domains, Sheide said. There are inconsistent utilization and application among users; variable architectures, formats and release schedules; and maintaining standard terminologies is time- and resource-intensive and takes away from time spent on patient care. Plus, standard terminologies may not contain local concepts.

The question now, Sheide said, is how do we make standard terminologies operate within systems and integrate legacy data. Up-to-date mapping is required so that providers are meeting Meaningful Use but also getting correct data capture, she said.

Please share your experience as you work to improve interoperability and quality of care.

Beth Walsh

Editor, Clinical Innovation + Technology