Learning Session 3: Using Electronic Health Records Data to Build Registries for Quality Improvement

Speaker: Brent Egan,  MD, Professor of Medicine at the University of South Carolina School of Medicine, Greenville and serves as the Medical Director for the Care Coordination Institute

Date: July 14, 2014, 4pm ET, 3pm CT

Listen to the presentation here. (23 minutes)

Resources:

Objectives of the Presentation: 

  • Describe development of an EHR registry.
  • Identify key partners that need to be involved with developing an EHR registry.
  • Describe ways that EHRs have been and can be used to inform population-based interventions.

Main points to be covered:

  • Current use of an EHR data registry in South Carolina.
  • Discuss the realistic expectations for use of EHRs in hypertension control at this point in time.
  • What actions or collaborations can state public health agencies engage in with health care providers on the use of EHRs.

Main points presented:

  • Brief history of OQIUN, CCI - Began 1999 using data cards.  Started working with multiple practice sites using different EHRS in 2003; currently >350 clinical sites using >25 EHRS.  Relationships are critical to success!
  • Registry function -  NCQA Heart Disease / Stroke Prevention Recognition program reporting with 5 indicators (BP control [75%], Lipid panel [80%], Cholesterol (LDL) control [50%], aspirin or another antithrombotic [80%], smoking status / cessation advice or Rx [80%]. Score for each physician, composite for each clinic, comparison to all other providers / clinics in database.
  • Population management tool (all patients for each provider left vertical) - 5 indicators across the top and sortable columns.

Main take-away points:

  • Whenever possible use the EHRS as designed and maximize consistent use of discrete and structured field data.
  • Standardize data entry across the clinic and practice group.
  • Implement a BP measurement protocol that aims to obtain an accurate and representative BP in a discrete / structured field.
  • Make sure the medication list is accurate.
  • Incorporate labs into structured fields of the EHRS.
  • Agree on a BP treatment protocol that will work for most patients and adhere to it.
  • Maintain a hypertension registry with at least monthly updates and accountability.
  • To maximize benefit, use the ABCS of CVD prevention with actionable, POC information and support.