The increased use of electronic medical records and information technology could help facilitate data collecting and therefore improve quality measurement, says an author of the 5th annual National Healthcare Quality Report by the Agency for Healthcare Research and Quality, which indicates that the rates of quality and safety improvement are slowing down.
The AHRQs report showed that quality improved at a rate of 2.3% in 2007 while safety improved only 1%, based on 41 core measures. The AHRQ used more than 36 data sources to create an average annualized rate of change in improvement, said Jeff Brady, a physician and acting director of national healthcare reports for the AHRQ.
The AHRQ does modify the measures over time as standards of care change, which can make comparing the annual reports challenging, Brady said. Also some of the data sources used were never designed to answer quality questions, but the AHRQ has adapted those sources so the information can reflect quality measures. This move has helped reduce the need to engineer entirely new databases while applying existing data to quality measurements, Brady said.
But the federal agency recognizes there are limits to the data it uses for the report, and hopes to align the data sources with standardized definitions and measurements as they are developed, Brady said. We clearly see there are some gaps in what we can report because measures and data sources vary widely, he said.
Ideally, there would be a single national system from which to draw quality data, but were not there yet, he added.
Quality groups such as the Joint Commission are pushing for the creation of a standard that might make measuring such errors easier. Just last week, it released a white paper calling on the industry to develop a national data infrastructure using standardized measures and definitions that would support the exchange of information at the regional and community level.
Aligning several databases through one infrastructure would provide physicians with best practices for data exchange, which would lead to more comprehensive use of performance measurements, said Margaret VanAmringe, vice president of public policy and government relations for the Joint Commission.