Abstract
Objective: To determine the extent to which it is feasible to implement quality measures on electronic health records (EHRs) as currently implemented in pediatric health centers.
Methods: A survey of information technology professionals at 10 institutions that provide primary care services to adolescents. The survey asked whether data about care was being captured electronically across the nine domains relevant to adolescent well care: Screening, Health Risks, Sexual Health, Diagnosis and History, Laboratory Results, Prescriptions, Referrals, Forms Management, and Patient Demographics. For each domain, we developed a scale of the extent to which the EHR makes quality measurement feasible.
Results: Overall feasibility scores varied across centers from 34% to 85% and from 53% to 80% across care domains. One centre reported 100% feasibility for 8 of 10 care domains.
Conclusions: Electronic health records can facilitate quality improvement, but the feasibility of such use depends on the presence, validity, and accessibility of the quality data in the EHR. Even among the largest and most sophisticated pediatric EHR systems, quality of care measurement is not possible yet for all aspects of adolescent well care without manual effort to review and code data. Nevertheless, almost all quality measures were reported to be feasible in some systems.