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    Can we use automated data to assess quality of hypertension care

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    Authors
    Borzecki, Ann M.
    Wong, Ashley T.
    Hickey, Elaine C.
    Ash, Arlene S.
    Berlowitz, Dan R.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2004-08-10
    Keywords
    Aged
    Automation
    Blood Pressure
    Cohort Studies
    Female
    Health Services Research
    Humans
    Hypertension
    Male
    Middle Aged
    *Quality of Health Care
    Retrospective Studies
    United States
    United States Department of Veterans Affairs
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://www.ajmc.com/issue/managed-care/2004/2004-07-vol10-n7Pt2/Jul04-1812p473-479
    Abstract
    OBJECTIVE: To determine whether extractable blood pressure (BP) information available in a computerized patient record system (CPRS) could be used to assess quality of hypertension care independently of clinicians' notes. STUDY DESIGN: Retrospective cohort study of a random sample of hypertensive patients from 10 Department of Veterans Affairs (VA) sites across the country. METHODS: We abstracted BPs from electronic clinicians' notes for all medical visits of 981 hypertensive patients in 1999. We compared these with BP measurements available in a separate vitals signs file in the CPRS. We also evaluated whether assessments of performance varied by source by using patients' last documented BP reading. RESULTS: When the vital signs file and notes were combined, a BP measurement was taken for 71% of 6097 medical visits; 60% had a BP measurement only in the vital signs file. Combining sources, 43% of patients had a BP reading of less than 140/90 mm Hg; by site this varied (34%-51%). Vital signs file data alone yielded similar findings; site rankings by rates of BP control changed minimally. CONCLUSIONS: Current performance review programs collect clinical data from both clinicians' notes and automated sources as available. However, we found that notes contribute little information with respect to BP values beyond automated data alone. The VA's vital signs file is a prototypical automated data system that could make assessment of hypertension care more efficient in many settings.
    Source
    Am J Manag Care. 2004 Jul;10(7 Pt 2):473-9. Link to article on publisher's site
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47596
    PubMed ID
    15298233
    Related Resources
    Link to Article in PubMed
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    Population and Quantitative Health Sciences Publications

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