Making Public Performance Reporting Meaningful and Useful: Large Observational Studies of the Role of Electronic Health Records in Chronic Disease Care

• Activity Number: 392
• Type: Topic Contributed
• Date/Time: Tuesday, July 31, 2012 : 2:00 PM to 3:50 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Thomas Love*+
• Companies: Case Western Reserve University
• Keywords: electronic health records ; public reporting ; performance measurement ; observational studies ; health policy ; health care improvement

Abstract

Public reporting is a key part of health care improvement, but the transition from reporting to research is non-trivial.

Better Health Greater Cleveland is a regional alliance of people interested in improving health care. A notable focus is electronic health records-catalyzed public reporting of performance on standards for care and outcomes in chronic disease. Better Health has produced nine biannual reports on diabetes, hypertension and heart failure in the region, describing more than 100,000 patients, 400 providers, and 8 NE Ohio health systems.

Our work has transitioned from data collection and reporting alone to include publishable research. In a September 2011 NEJM article, we compared achievement of and improvement in diabetes quality standards for patients at practices with electronic vs. paper health records. Across all insurance types, electronic records were associated with higher achievement and faster improvement of care and outcome standards, after covariate adjustment. Recent work documents potentially replicable "best practices" gleaned in part from the data.

We describe some lessons learned, and identify open issues and opportunities for methodologists.