Clinical quality measurement. Comparing chart review and automated methodologies.

Abstract:

OBJECTIVES:This study investigates the use of data from automated systems within a large managed care plan to create indicators of clinical quality. METHODS:Measures from the first year of Health Plan Employer Data and Information Set, HEDIS 2.0, are used to compare chart review and automated analysis methodologies. The contributions of various data systems in creating clinical quality measures are evaluated. RESULTS:Chart review data usually are better for creating clinical quality indicators, although the level of agreement between the two methodologies often is quite high. Computerized patient record systems are found to be the most reliable automated data source, and automated claims are found to be the least reliable. This study's findings suggest that automated encounter systems may provide relatively reliable data. CONCLUSIONS:Managed care plans may not want to rely on automated data alone for clinical quality measurement. The results reported here support the use of combined methodologies such as the "hybrid" method, which utilizes both automated and chart-review data.

journal_name

Med Care

journal_title

Medical care

authors

Dresser MV,Feingold L,Rosenkranz SL,Coltin KL

doi

10.1097/00005650-199706000-00001

subject

Has Abstract

pub_date

1997-06-01 00:00:00

pages

539-52

issue

6

eissn

0025-7079

issn

1537-1948

journal_volume

35

pub_type

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