The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study
BackgroundRoutine collection of disease activity (DA) and patient-reported outcomes (PROs) in rheumatoid arthritis (RA) are nationally endorsed quality measures and critical components of a treat-to-target approach. However, little is known about the role electronic health re...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-11-01
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| Series: | JMIR Medical Informatics |
| Online Access: | https://medinform.jmir.org/2021/11/e31186 |
| _version_ | 1797735539969884160 |
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| author | Nevin Hammam Zara Izadi Jing Li Michael Evans Julia Kay Stephen Shiboski Gabriela Schmajuk Jinoos Yazdany |
| author_facet | Nevin Hammam Zara Izadi Jing Li Michael Evans Julia Kay Stephen Shiboski Gabriela Schmajuk Jinoos Yazdany |
| author_sort | Nevin Hammam |
| collection | DOAJ |
| description |
BackgroundRoutine collection of disease activity (DA) and patient-reported outcomes (PROs) in rheumatoid arthritis (RA) are nationally endorsed quality measures and critical components of a treat-to-target approach. However, little is known about the role electronic health record (EHR) systems play in facilitating performance on these measures.
ObjectiveUsing the American College Rheumatology’s (ACR’s) RISE registry, we analyzed the relationship between EHR system and performance on DA and functional status (FS) quality measures.
MethodsWe analyzed data collected in 2018 from practices enrolled in RISE. We assessed practice-level performance on quality measures that require DA and FS documentation. Multivariable linear regression and zero-inflated negative binomial models were used to examine the independent effect of EHR system on practice-level quality measure performance, adjusting for practice characteristics and patient case-mix.
ResultsIn total, 220 included practices cared for 314,793 patients with RA. NextGen was the most commonly used EHR system (34.1%). We found wide variation in performance on DA and FS quality measures by EHR system (median 30.1, IQR 0-74.8, and median 9.0, IQR 0-74.2), respectively). Even after adjustment, NextGen practices performed significantly better than Allscripts on the DA measure (51.4% vs 5.0%; P<.05) and significantly better than eClinicalWorks and eMDs on the FS measure (49.3% vs 29.0% and 10.9%; P<.05).
ConclusionsPerformance on national RA quality measures was associated with the EHR system, even after adjusting for practice and patient characteristics. These findings suggest that future efforts to improve quality of care in RA should focus not only on provider performance reporting but also on developing and implementing rheumatology-specific standards across EHRs. |
| first_indexed | 2024-03-12T13:00:32Z |
| format | Article |
| id | doaj.art-7befbcff656d4ad4a713768e80873269 |
| institution | Directory Open Access Journal |
| issn | 2291-9694 |
| language | English |
| last_indexed | 2024-03-12T13:00:32Z |
| publishDate | 2021-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Medical Informatics |
| spelling | doaj.art-7befbcff656d4ad4a713768e808732692023-08-28T19:46:12ZengJMIR PublicationsJMIR Medical Informatics2291-96942021-11-01911e3118610.2196/31186The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational StudyNevin Hammamhttps://orcid.org/0000-0002-7754-5581Zara Izadihttps://orcid.org/0000-0002-1867-0905Jing Lihttps://orcid.org/0000-0002-3298-2112Michael Evanshttps://orcid.org/0000-0001-9625-212XJulia Kayhttps://orcid.org/0000-0002-8081-5896Stephen Shiboskihttps://orcid.org/0000-0002-9257-2609Gabriela Schmajukhttps://orcid.org/0000-0003-2687-5043Jinoos Yazdanyhttps://orcid.org/0000-0002-3508-4094 BackgroundRoutine collection of disease activity (DA) and patient-reported outcomes (PROs) in rheumatoid arthritis (RA) are nationally endorsed quality measures and critical components of a treat-to-target approach. However, little is known about the role electronic health record (EHR) systems play in facilitating performance on these measures. ObjectiveUsing the American College Rheumatology’s (ACR’s) RISE registry, we analyzed the relationship between EHR system and performance on DA and functional status (FS) quality measures. MethodsWe analyzed data collected in 2018 from practices enrolled in RISE. We assessed practice-level performance on quality measures that require DA and FS documentation. Multivariable linear regression and zero-inflated negative binomial models were used to examine the independent effect of EHR system on practice-level quality measure performance, adjusting for practice characteristics and patient case-mix. ResultsIn total, 220 included practices cared for 314,793 patients with RA. NextGen was the most commonly used EHR system (34.1%). We found wide variation in performance on DA and FS quality measures by EHR system (median 30.1, IQR 0-74.8, and median 9.0, IQR 0-74.2), respectively). Even after adjustment, NextGen practices performed significantly better than Allscripts on the DA measure (51.4% vs 5.0%; P<.05) and significantly better than eClinicalWorks and eMDs on the FS measure (49.3% vs 29.0% and 10.9%; P<.05). ConclusionsPerformance on national RA quality measures was associated with the EHR system, even after adjusting for practice and patient characteristics. These findings suggest that future efforts to improve quality of care in RA should focus not only on provider performance reporting but also on developing and implementing rheumatology-specific standards across EHRs.https://medinform.jmir.org/2021/11/e31186 |
| spellingShingle | Nevin Hammam Zara Izadi Jing Li Michael Evans Julia Kay Stephen Shiboski Gabriela Schmajuk Jinoos Yazdany The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study JMIR Medical Informatics |
| title | The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study |
| title_full | The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study |
| title_fullStr | The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study |
| title_full_unstemmed | The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study |
| title_short | The Relationship Between Electronic Health Record System and Performance on Quality Measures in the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) Registry: Observational Study |
| title_sort | relationship between electronic health record system and performance on quality measures in the american college of rheumatology s rheumatology informatics system for effectiveness rise registry observational study |
| url | https://medinform.jmir.org/2021/11/e31186 |
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