Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults

John Heintzman, Steffani Bailey, Megan J. Hoopes, Thuy Le, Rachel Gold, Jean P. O'Malley, Stuart Cowburn, Miguel Marino, Alex Krist, Jennifer Devoe

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

To compare the agreement of electronic health record (EHR) data versus Medicaid claims data in documenting adult preventive care. Insurance claims are commonly used to measure care quality. EHR data could serve this purpose, but little information exists about how this source compares in service documentation. For 13 101 Medicaid-insured adult patients attending 43 Oregon community health centers, we compared documentation of 11 preventive services, based on EHR versus Medicaid claims data. Documentation was comparable for most services. Agreement was highest for influenza vaccination (κ = 0.77; 95% CI 0.75 to 0.79), cholesterol screening (κ = 0.80; 95% CI 0.79 to 0.81), and cervical cancer screening (κ = 0.71; 95% CI 0.70 to 0.73), and lowest on services commonly referred out of primary care clinics and those that usually do not generate claims. EHRs show promise for use in quality reporting. Strategies to maximize data capture in EHRs are needed to optimize the use of EHR data for service documentation.

Original languageEnglish (US)
Pages (from-to)720-724
Number of pages5
JournalJournal of the American Medical Informatics Association
Volume21
Issue number4
DOIs
StatePublished - 2014

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Preventive Medicine
Electronic Health Records
Medicaid
Documentation
Community Health Centers
Quality of Health Care
Insurance
Early Detection of Cancer
Uterine Cervical Neoplasms
Human Influenza
Primary Health Care
Vaccination
Cholesterol

ASJC Scopus subject areas

  • Health Informatics

Cite this

Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults. / Heintzman, John; Bailey, Steffani; Hoopes, Megan J.; Le, Thuy; Gold, Rachel; O'Malley, Jean P.; Cowburn, Stuart; Marino, Miguel; Krist, Alex; Devoe, Jennifer.

In: Journal of the American Medical Informatics Association, Vol. 21, No. 4, 2014, p. 720-724.

Research output: Contribution to journalArticle

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