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. 2016 Nov;68(11):1579-1590.
doi: 10.1002/acr.22984.

Development of the American College of Rheumatology's Rheumatoid Arthritis Electronic Clinical Quality Measures

Jinoos Yazdany  1 , Mark Robbins  2 , Gabriela Schmajuk  3 , Sonali Desai  4 , Diane Lacaille  5 , Tuhina Neogi  6 , Jasvinder A Singh  7 , Mark Genovese  8 , Rachel Myslinski  9 , Natalie Fisk  9 , Melissa Francisco  9 , Eric Newman  10
Affiliations

Development of the American College of Rheumatology's Rheumatoid Arthritis Electronic Clinical Quality Measures

Jinoos Yazdany et al. Arthritis Care Res (Hoboken). 2016 Nov.

Abstract

Objective: Electronic clinical quality measures (eCQMs) rely on computer algorithms to extract data from electronic health records (EHRs). On behalf of the American College of Rheumatology (ACR), we sought to develop and test eCQMs for rheumatoid arthritis (RA).

Methods: Drawing from published ACR guidelines, a working group developed candidate RA process measures and subsequently assessed face validity through an interdisciplinary panel of health care stakeholders. A public comment period followed. Measures that passed these levels of review were electronically specified using the quality data model, which provides standard nomenclature for data elements (category, datatype, and value sets) obtained through an EHR. For each eCQM, 3 clinical sites using different EHR systems tested the scientific feasibility and validity of measures. Measures appropriate for accountability were presented for national endorsement.

Results: Expert panel validity ratings were high for all measures (median 8-9 of 9). Health system performance on the eCQMs was 53.6% for RA disease activity assessment, 69.1% for functional status assessment, 93.1% for disease-modifying antirheumatic drug (DMARD) use, and 72.8% for tuberculosis screening. Kappa statistics, which evaluated whether the eCQM validly captured data obtained from manual EHR chart review, demonstrated moderate to substantial agreement (0.54 for functional status assessment, 0.73 for tuberculosis screening, 0.84 for disease activity, and 0.85 for DMARD use).

Conclusion: Four eCQMs for RA have achieved national endorsement and are recommended for use in federal quality reporting programs. Implementation and further refinement of these measures is ongoing in the ACR's registry, the Rheumatology Informatics System for Effectiveness (RISE).

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Figure 1
Figure 1. Overview of the American College of Rheumatology’s Rheumatoid Arthritis electronic clinical quality measure development program
RA=rheumatoid arthritis; ACR=American College of Rheumatology
See this image and copyright information in PMC

References

    1. National Quality Forum. Measure Prioritization Advisory Committee Report. Prioritization of High-Impact Medicare Conditions and Measure Gaps. 2010 [cited December 26, 2014]; Available from: http://www.qualityforum.org/projects/prioritization.aspx.
    1. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis and rheumatism. 2008;58(1):15–25. - PubMed
    1. Schmajuk G, Trivedi AN, Solomon DH, Yelin E, Trupin L, Chakravarty EF, et al. Receipt of disease-modifying antirheumatic drugs among patients with rheumatoid arthritis in Medicare managed care plans. Jama. 2011;305(5):480–6. - PMC - PubMed
    1. Desai SP, Yazdany J. Quality measurement and improvement in rheumatology: rheumatoid arthritis as a case study. Arthritis and rheumatism. 2011;63(12):3649–60. - PMC - PubMed
    1. Yazdany J, et al. eCQM paper. (under review)

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