Data Collection Equals Quality Improvement

"The reason some physicians don't understand how to evaluate their of care is because they have paper charts and don't know what level of care they currently provide," said Lori Dickerson, Pharm.D., associate professor and assistant residency program director at Trident Family Medicine Residency Program in Charleston, S.C.

"Physicians tend to overestimate the degree of quality they provide; an electronic health record gives a more accurate estimate," she said.

The second- and third-year residents participate in Trident's Clinical Scholars Program, which gives them an opportunity to evaluate and improve patient care using information gleaned from electronic patient records.

The residency program uses Physician Micro System Inc.'s Practice Partner software and participates in PMSI's Practice Partner Research Network.

Network participants export patient data (stripped of all personal health information) to the network each quarter, and that data, collected on hundreds of quality indicators, is sorted by statisticians and fed back to the submitting physicians quarterly.

The latest report to Trident from the network included statistics on the proportion of:

If Trident's numbers sit below the national benchmark, that's impetus for improvement, and that's where the residents go to work. In small teams, they select areas of interest, search electronic records for a pattern to isolate a problem and then suggest an action that may lead to a solution.

"This (EHR) is an incredible tool," said Dickerson. By making ever-so-slight adjustments in office procedure, staff can quickly evaluate progress. "You don't wait for two years, you wait for six weeks," she said. "The EHR allows everybody on the health care team to be involved in quality."

Residents finalize their projects and present results to during at least two meetings in the spring. All projects are approved by our the institutional review board for human research, said Dickerson, and the Clinical Scholars Program fulfills the Residency Review Council's requirement that all residents must be involved in practice-based learning and improvement.