Feasibility of evaluating the CHIPRA care quality measures in electronic health record data

Rachel Gold, Heather Angier, Rita Mangione-Smith, Charles Gallia, Patti J. McIntire, Stuart Cowburn, Carrie Tillotson, Jennifer Devoe

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) includes provisions for identifying standardized pediatric care quality measures. These 24 "CHIPRA measures" were designed to be evaluated by using claims data from health insurance plan populations. Such data have limited ability to evaluate population health, especially among uninsured people. The rapid expansion of data from electronic health records (EHRs) may help address this limitation by augmenting claims data in care quality assessments. We outline how to operationalize many of the CHIPRA measures for application in EHR data through a case study of a network of ≥40 outpatient community health centers in 2009-2010 with a single EHR. We assess the differences seen when applying the original claims-based versus adapted EHR-based specifications, using 2 CHIPRA measures (Chlamydia screening among sexually active female patients; BMI percentile documentation) as examples. Sixteen of the original CHIPRA measures could feasibly be evaluated in this dataset. Three main adaptations were necessary (specifying a visitbased population denominator, calculating some pregnancy-related factors by using EHR data, substituting for medication dispense data). Although it is feasible to adapt many of the CHIPRA measures for use in outpatient EHR data, information is gained and lost depending on how numerators and denominators are specified. We suggest first steps toward application of the CHIPRA measures in uninsured populations, and in EHR data. The results highlight the importance of considering the limitations of the original CHIPRA measures in care quality evaluations.

Original languageEnglish (US)
Pages (from-to)139-149
Number of pages11
JournalPediatrics
Volume130
Issue number1
DOIs
StatePublished - Jul 2012

Fingerprint

Electronic Health Records
Quality of Health Care
Population
Outpatients
Community Health Centers
Chlamydia
Children's Health Insurance Program
Health
Children's Health
Health Insurance
Documentation
Pediatrics
Pregnancy

Keywords

  • CHIPRA measures
  • Electronic health record data collection
  • Health care quality assessment
  • Health care quality indicators
  • Pediatric care quality assessment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Gold, R., Angier, H., Mangione-Smith, R., Gallia, C., McIntire, P. J., Cowburn, S., ... Devoe, J. (2012). Feasibility of evaluating the CHIPRA care quality measures in electronic health record data. Pediatrics, 130(1), 139-149. https://doi.org/10.1542/peds.2011-3705

Feasibility of evaluating the CHIPRA care quality measures in electronic health record data. / Gold, Rachel; Angier, Heather; Mangione-Smith, Rita; Gallia, Charles; McIntire, Patti J.; Cowburn, Stuart; Tillotson, Carrie; Devoe, Jennifer.

In: Pediatrics, Vol. 130, No. 1, 07.2012, p. 139-149.

Research output: Contribution to journalArticle

Gold, R, Angier, H, Mangione-Smith, R, Gallia, C, McIntire, PJ, Cowburn, S, Tillotson, C & Devoe, J 2012, 'Feasibility of evaluating the CHIPRA care quality measures in electronic health record data', Pediatrics, vol. 130, no. 1, pp. 139-149. https://doi.org/10.1542/peds.2011-3705
Gold R, Angier H, Mangione-Smith R, Gallia C, McIntire PJ, Cowburn S et al. Feasibility of evaluating the CHIPRA care quality measures in electronic health record data. Pediatrics. 2012 Jul;130(1):139-149. https://doi.org/10.1542/peds.2011-3705
Gold, Rachel ; Angier, Heather ; Mangione-Smith, Rita ; Gallia, Charles ; McIntire, Patti J. ; Cowburn, Stuart ; Tillotson, Carrie ; Devoe, Jennifer. / Feasibility of evaluating the CHIPRA care quality measures in electronic health record data. In: Pediatrics. 2012 ; Vol. 130, No. 1. pp. 139-149.
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