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COMMENTS & OPINIONS
Beware the Burden of Measurement
Christine A. Sinsky, MD
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Errors are not always in the performance, sometimes they are in the measurement. Persell et al1 document the limitations of using automated measurements within an electronic health record for quality audits. The authors found that 15% to 81% of apparent quality failures were actually audit failures. When the auditors accessed all of the data within the electronic health record, including narrative information, many apparent quality failures were reclassified as compliant.
An audit technique chosen for its audit convenience (use of only digitalized data) misclassified compliant care as quality failure. A more in-depth audit technique (full medical chart review) identified the limitations of relying simply on digital data. So far so good.
The problem is in the authors' proposed solutions. As in many "work-arounds," the authors attempt to solve a complex problem by adding yet another responsibility to the already beleaguered front-line clinician. The clinician is to . . . [Full Text of this Article]
AUTHOR INFORMATION
RELATED LETTER
Beware the Burden of Measurement—Reply
Stephen D. Persell, Jason A. Thompson, Karen S. Kmetik, and David W. Baker
Arch Intern Med. 2007;167(9):972.
EXTRACT
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RELATED ARTICLE
Assessing the Validity of National Quality Measures for Coronary Artery Disease Using an Electronic Health Record
Stephen D. Persell, Jennifer M. Wright, Jason A. Thompson, Karen S. Kmetik, and David W. Baker
Arch Intern Med. 2006;166(20):2272-2277.
ABSTRACT
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