The ability to accurately assess physician performance in cardiology is critical—especially with the push for quality improvement in the age of value-based care—but it remains a challenge, according to a new study.
The report published in JAMA Network Open questions the validity of two techniques commonly used by physicians: medical record abstraction (MRA) and extracting data from electronic health records (EHRs). It compared these from a subset of the 2016 aspirin, BP, and smoking performance data from the Healthy Hearts for Oklahoma Project.
Overall, MRA resulted in higher performance scores compared with EHR–generated reports. Observed performance scores related to aspirin were 76% when using MRA data and 74.9% when using EHR data. Scores related to blood pressure were 80.6% when using MRA data and 75.1% when using EHR data; in the category of smoking, it was 85.7% for MRA and 75.4% for EHR.
“These results raise significant concerns about the comparability and validity of different methods used to determine performance scores, which has important implications for quality improvement activities and implementation of value-based payment models,” lead author Juell Homco, PhD, MPH, University of Oklahoma Health Sciences Center in Tulsa, and his colleagues wrote.
Ultimately, more research is needed to identify the sources of these differences.
“Given the importance of performance measurement to quality improvement efforts and value-based payment models, more extensive study is required to better understand the source of these differences so that improvements in care quality can be measured with confidence,” the authors said.
Read the full study here