TY - JOUR
T1 - From simply inaccurate to complex and inaccurate
T2 - complexity in standards-based quality measures.
AU - Dorr, David A.
AU - Cohen, Aaron M.
AU - Williams, Marsha Pierre Jacques
AU - Hurdle, John
PY - 2011
Y1 - 2011
N2 - Quality measurement has been slow to make a major impact in health care. Initial measures were too simple to affect outcomes of importance. Incentive programs such as Meaningful Use encourage better measures, but in process may become more complex. We evaluated the measures selected for Meaningful Use in two ways: we counted unique concept identifiers, taxonomies, and aggregated concepts as measures of complexity; and we surveyed informatics professionals to assess difficulty. There were 20,316 unique concept identifiers, 35 taxonomies, and 317 aggregated concepts across the 45 measures. Half the respondents reported measures at least moderately difficult. The number of identifiers was associated with fewer implementations (r=-.37); rating-of-difficulty was associated with more taxonomies (r=.24). The impact on accuracy may be substantial when moving to measures intended to be more relevant to clinical outcomes but requiring the use of more taxonomies, unused structured concept identifiers, or concepts only in free text fields.
AB - Quality measurement has been slow to make a major impact in health care. Initial measures were too simple to affect outcomes of importance. Incentive programs such as Meaningful Use encourage better measures, but in process may become more complex. We evaluated the measures selected for Meaningful Use in two ways: we counted unique concept identifiers, taxonomies, and aggregated concepts as measures of complexity; and we surveyed informatics professionals to assess difficulty. There were 20,316 unique concept identifiers, 35 taxonomies, and 317 aggregated concepts across the 45 measures. Half the respondents reported measures at least moderately difficult. The number of identifiers was associated with fewer implementations (r=-.37); rating-of-difficulty was associated with more taxonomies (r=.24). The impact on accuracy may be substantial when moving to measures intended to be more relevant to clinical outcomes but requiring the use of more taxonomies, unused structured concept identifiers, or concepts only in free text fields.
UR - http://www.scopus.com/inward/record.url?scp=84874213855&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874213855&partnerID=8YFLogxK
M3 - Article
C2 - 22195085
AN - SCOPUS:84874213855
SN - 1559-4076
VL - 2011
SP - 331
EP - 338
JO - AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
JF - AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
ER -