TY - JOUR
T1 - Feasibility of evaluating the CHIPRA care quality measures in electronic health record data
AU - Gold, Rachel
AU - Angier, Heather
AU - Mangione-Smith, Rita
AU - Gallia, Charles
AU - McIntire, Patti J.
AU - Cowburn, Stuart
AU - Tillotson, Carrie
AU - DeVoe, Jennifer E.
PY - 2012/7
Y1 - 2012/7
N2 - The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes provisions for identifying standardized pediatric care quality measures. These 24 "CHIPRA measures" were designed to be evaluated by using claims data from health insurance plan populations. Such data have limited ability to evaluate population health, especially among uninsured people. The rapid expansion of data from electronic health records (EHRs) may help address this limitation by augmenting claims data in care quality assessments. We outline how to operationalize many of the CHIPRA measures for application in EHR data through a case study of a network of ≥40 outpatient community health centers in 2009-2010 with a single EHR. We assess the differences seen when applying the original claims-based versus adapted EHR-based specifications, using 2 CHIPRA measures (Chlamydia screening among sexually active female patients; BMI percentile documentation) as examples. Sixteen of the original CHIPRA measures could feasibly be evaluated in this dataset. Three main adaptations were necessary (specifying a visitbased population denominator, calculating some pregnancy-related factors by using EHR data, substituting for medication dispense data). Although it is feasible to adapt many of the CHIPRA measures for use in outpatient EHR data, information is gained and lost depending on how numerators and denominators are specified. We suggest first steps toward application of the CHIPRA measures in uninsured populations, and in EHR data. The results highlight the importance of considering the limitations of the original CHIPRA measures in care quality evaluations.
AB - The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes provisions for identifying standardized pediatric care quality measures. These 24 "CHIPRA measures" were designed to be evaluated by using claims data from health insurance plan populations. Such data have limited ability to evaluate population health, especially among uninsured people. The rapid expansion of data from electronic health records (EHRs) may help address this limitation by augmenting claims data in care quality assessments. We outline how to operationalize many of the CHIPRA measures for application in EHR data through a case study of a network of ≥40 outpatient community health centers in 2009-2010 with a single EHR. We assess the differences seen when applying the original claims-based versus adapted EHR-based specifications, using 2 CHIPRA measures (Chlamydia screening among sexually active female patients; BMI percentile documentation) as examples. Sixteen of the original CHIPRA measures could feasibly be evaluated in this dataset. Three main adaptations were necessary (specifying a visitbased population denominator, calculating some pregnancy-related factors by using EHR data, substituting for medication dispense data). Although it is feasible to adapt many of the CHIPRA measures for use in outpatient EHR data, information is gained and lost depending on how numerators and denominators are specified. We suggest first steps toward application of the CHIPRA measures in uninsured populations, and in EHR data. The results highlight the importance of considering the limitations of the original CHIPRA measures in care quality evaluations.
KW - CHIPRA measures
KW - Electronic health record data collection
KW - Health care quality assessment
KW - Health care quality indicators
KW - Pediatric care quality assessment
UR - http://www.scopus.com/inward/record.url?scp=84863507807&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863507807&partnerID=8YFLogxK
U2 - 10.1542/peds.2011-3705
DO - 10.1542/peds.2011-3705
M3 - Article
C2 - 22711724
AN - SCOPUS:84863507807
SN - 0031-4005
VL - 130
SP - 139
EP - 149
JO - Pediatrics
JF - Pediatrics
IS - 1
ER -