American college of rheumatology quality indicators for rheumatoid arthritis: Benchmarking, variability, and opportunities to improve quality of care using the electronic health record

摘要: Objective To measure how rheumatologists across our health system performed with the American College of Rheumatology (ACR) quality indicators (QIs) for rheumatoid arthritis (RA) and methotrexate (MTX) drug safety, to develop opportunities improvement. Methods An electronic record (EHR) review 1,062 unique RA patients seen by 15 in a 1-year period was performed. Percentage each QI met, reasons why metric not performance based on years experience were evaluated. Results The percentage met high QI-2 (RA disease-modifying antirheumatic use; 94%), QI-3 (intervention if worse; 85%), QI-4 (MTX risks discussion; 87%). lower QI-1 core data set; 69%), QI-5 baseline studies; 41%), QI-6 followup 46%). low due most physicians missing single test, because few driving down. Better ≤10 versus >10 (90% 64%; odds ratio [OR] 4.21, P = 0.004) (96% 82%; OR 4.47, 0.019). EHR chart this population required 179.3 hours. Conclusion Measurement allows us better understand care that we deliver. In systematic benchmarking ACR QIs large cohort, excellent treatment–related QIs. Significant variability noted MTX monitoring measures, which can be addressed using process redesign techniques.