OBJECTIVE: To study the feasibility of using electronic medical record (EMR) data from the Deliver Primary Healthcare Information (DELPHI) database to measure quality of care for patients with congestive heart failure (CHF) in primary care and to determine the percentage of patients with CHF receiving the recommended care. DESIGN: Items listed on the Ontario Ministry of Health and Long-Term Care Heart Failure Patient Care Flow Sheet (CHF flow sheet) were assessed and measured using EMRs of patients diagnosed with CHF between October 1, 2005, and September 30, 2008. SETTING: Ten primary health care practices in southwestern Ontario. PARTICIPANTS: Four hundred eighty-eight patients who were considered to have CHF because at least 1 of the following was indicated in their EMRs: an International Classification of Diseases billing code for CHF (category 428), an International Classification of Primary Care diagnosis code for heart failure (ie, K77), or "CHF" reported on the problem list. MAIN OUTCOME MEASURES: Number of CHF flow sheet items that were measurable using EMR data from the DELPHI database. Percentage of patients with CHF receiving required quality-of-care items since the date of diagnosis. RESULTS: The DELPHI database contained information on 60 (65.9%) of the 91 items identified using the CHF flow sheet. The recommended tests and procedures were recorded infrequently: 55.5% of patients with CHF had chest radiographs; 32.6% had electrocardiograms; 32.2% had echocardiograms; 30.5% were prescribed angiotensin-converting enzyme inhibitors; 20.9% were prescribed β-blockers; and 15.8% were prescribed angiotensin II receptor blockers. CONCLUSION: Low frequencies of recommended care items for patients with CHF were recorded in the EMR. Physicians explained that CHF care was documented in areas of the EMR that contained patient identifiers, such as the encounter notes, and was therefore not part of the DELPHI database. Extractable information from the EMR does not provide a complete picture of the quality of care provided to patients with CHF.
OBJECTIVE: To study the feasibility of using electronic medical record (EMR) data from the Deliver Primary Healthcare Information (DELPHI) database to measure quality of care for patients with congestive heart failure (CHF) in primary care and to determine the percentage of patients with CHF receiving the recommended care. DESIGN: Items listed on the Ontario Ministry of Health and Long-Term Care Heart FailurePatient Care Flow Sheet (CHF flow sheet) were assessed and measured using EMRs of patients diagnosed with CHF between October 1, 2005, and September 30, 2008. SETTING: Ten primary health care practices in southwestern Ontario. PARTICIPANTS: Four hundred eighty-eight patients who were considered to have CHF because at least 1 of the following was indicated in their EMRs: an International Classification of Diseases billing code for CHF (category 428), an International Classification of Primary Care diagnosis code for heart failure (ie, K77), or "CHF" reported on the problem list. MAIN OUTCOME MEASURES: Number of CHF flow sheet items that were measurable using EMR data from the DELPHI database. Percentage of patients with CHF receiving required quality-of-care items since the date of diagnosis. RESULTS: The DELPHI database contained information on 60 (65.9%) of the 91 items identified using the CHF flow sheet. The recommended tests and procedures were recorded infrequently: 55.5% of patients with CHF had chest radiographs; 32.6% had electrocardiograms; 32.2% had echocardiograms; 30.5% were prescribed angiotensin-converting enzyme inhibitors; 20.9% were prescribed β-blockers; and 15.8% were prescribed angiotensin II receptor blockers. CONCLUSION: Low frequencies of recommended care items for patients with CHF were recorded in the EMR. Physicians explained that CHF care was documented in areas of the EMR that contained patient identifiers, such as the encounter notes, and was therefore not part of the DELPHI database. Extractable information from the EMR does not provide a complete picture of the quality of care provided to patients with CHF.
Authors: J Malcom O Arnold; Jonathan G Howlett; Paul Dorian; Anique Ducharme; Nadia Giannetti; Haissam Haddad; George A Heckman; Andrew Ignaszewski; Debra Isaac; Philip Jong; Peter Liu; Elizabeth Mann; Robert S McKelvie; Gordon W Moe; John D Parker; Anna M Svendsen; Ross T Tsuyuki; Kelly O'Halloran; Heather J Ross; Vivek Rao; Errol J Sequeira; Michel White Journal: Can J Cardiol Date: 2007-01 Impact factor: 5.223
Authors: J Malcolm O Arnold; Peter Liu; Catherine Demers; Paul Dorian; Nadia Giannetti; Haissam Haddad; George A Heckman; Jonathan G Howlett; Andrew Ignaszewski; David E Johnstone; Philip Jong; Robert S McKelvie; Gordon W Moe; John D Parker; Vivek Rao; Heather J Ross; Errol J Sequeira; Anna M Svendsen; Koon Teo; Ross T Tsuyuki; Michel White Journal: Can J Cardiol Date: 2006-01 Impact factor: 5.223
Authors: Grant M Russell; Simone Dahrouge; William Hogg; Robert Geneau; Laura Muldoon; Meltem Tuna Journal: Ann Fam Med Date: 2009 Jul-Aug Impact factor: 5.166
Authors: Henk Harkema; Wendy W Chapman; Melissa Saul; Evan S Dellon; Robert E Schoen; Ateev Mehrotra Journal: J Am Med Inform Assoc Date: 2011-09-21 Impact factor: 4.497