Comments on: Which Comes First — EHR or Quality Improvement? http://chqpr.org/blog/index.php/2009/02/which-comes-first-ehr-or-quality-improvement/ Fri, 21 Jan 2011 22:19:06 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Jean Sale-Shaw http://chqpr.org/blog/index.php/2009/02/which-comes-first-ehr-or-quality-improvement/comment-page-1/#comment-242 Jean Sale-Shaw Wed, 31 Mar 2010 17:58:08 +0000 http://chqpr.org/blog/?p=45#comment-242 aha, the capacity of an EHR to do a query. Now I understand. Thanks so much for clarifying. (Recent registered user of CHQPR website. Learned about your org./website while working on a paper in my MSN program last semester whose topic was, loosely, Disease Mgm't. (Nurse Led) in CHF and its potential impact on reducing readmissions amongst Medicare benefs. Got the idea from a May 2009 article in the NYTimes on a hospital-based program in the mid-west that was reducing admissions but might be abandoned due to the cost of operating it. I think that you/CHQPR and "ACOs" were quoted by the writer. I really appreciate the clarity of your mission and now that I have looked through the tabs on the website I see that CHQPR is partnered with NRHI and their focused collabs. around 'true' or truer payment reform.) aha, the capacity of an EHR to do a query. Now I understand. Thanks so much for clarifying.
(Recent registered user of CHQPR website. Learned about your org./website while working on a paper in my MSN program last semester whose topic was, loosely, Disease Mgm’t. (Nurse Led) in CHF and its potential impact on reducing readmissions amongst Medicare benefs. Got the idea from a May 2009 article in the NYTimes on a hospital-based program in the mid-west that was reducing admissions but might be abandoned due to the cost of operating it. I think that you/CHQPR and “ACOs” were quoted by the writer. I really appreciate the clarity of your mission and now that I have looked through the tabs on the website I see that CHQPR is partnered with NRHI and their focused collabs. around ‘true’ or truer payment reform.)

]]> By: Harold Miller http://chqpr.org/blog/index.php/2009/02/which-comes-first-ehr-or-quality-improvement/comment-page-1/#comment-238 Harold Miller Sun, 28 Mar 2010 20:08:43 +0000 http://chqpr.org/blog/?p=45#comment-238 A registry is a list of patients and selected information about those patients that is used for one or both of two purposes: (1) to identify groups of patients that have not received something they should have received, and (2) to analyze reasons why certain patients have better outcomes than others. So, for example, if I have a diabetic registry, I would enter the names of all of my patients with diabetes into the registry and record anytime they come in for an HbA1c test. Every month, I could query the registry to find out which patients had not had their HBA1c checked recently and call them to get them into the office, and I could also pull the list of those who hadn't had their HBA1c checked to see if there were any common elements among them. The information that goes in the registry is a subset of the information that would go in the EHR. The problem with many EHRs is that they don't give you the ability to do queries like those defined above. You may only be able to find out which patients haven't had their HBA1c checked by tediously going through each patient's record. The EHR may remind you when the patient comes in that they should have their HBA1c checked, but it may not remind you to have them come in in the first place. Moreover, an EHR is overkill if what you really want to do is track a specific, small set of information about a specific set of patients. A registry is a list of patients and selected information about those patients that is used for one or both of two purposes: (1) to identify groups of patients that have not received something they should have received, and (2) to analyze reasons why certain patients have better outcomes than others. So, for example, if I have a diabetic registry, I would enter the names of all of my patients with diabetes into the registry and record anytime they come in for an HbA1c test. Every month, I could query the registry to find out which patients had not had their HBA1c checked recently and call them to get them into the office, and I could also pull the list of those who hadn’t had their HBA1c checked to see if there were any common elements among them.
The information that goes in the registry is a subset of the information that would go in the EHR. The problem with many EHRs is that they don’t give you the ability to do queries like those defined above. You may only be able to find out which patients haven’t had their HBA1c checked by tediously going through each patient’s record. The EHR may remind you when the patient comes in that they should have their HBA1c checked, but it may not remind you to have them come in in the first place. Moreover, an EHR is overkill if what you really want to do is track a specific, small set of information about a specific set of patients.

]]> By: Jean http://chqpr.org/blog/index.php/2009/02/which-comes-first-ehr-or-quality-improvement/comment-page-1/#comment-237 Jean Sun, 28 Mar 2010 02:44:55 +0000 http://chqpr.org/blog/?p=45#comment-237 Can you describe what exactly is a patient "registry". Having worked some years ago in TB control at a local health department we did have access to the TB registry of patients - and this was before EHRs were being installed in community and private physicians' and OPD/hospital systems' offices - but I am forgetting the registry's main purposes, who created and maintained it (well, the health department, but I mean did it demand a lot of back stage staffing??). In this case, the registry was comprised of all reported cases of TB disease and infection and the health commissioner signed off and closed the case once TB staff verified patient's having completed treatment. Also, how does a registry differ from an EHR? Is it merely derived from a query of the EHR database? Can you describe what exactly is a patient “registry”. Having worked some years ago in TB control at a local health department we did have access to the TB registry of patients – and this was before EHRs were being installed in community and private physicians’ and OPD/hospital systems’ offices – but I am forgetting the registry’s main purposes, who created and maintained it (well, the health department, but I mean did it demand a lot of back stage staffing??). In this case, the registry was comprised of all reported cases of TB disease and infection and the health commissioner signed off and closed the case once TB staff verified patient’s having completed treatment.

Also, how does a registry differ from an EHR? Is it merely derived from a query of the EHR database?

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