Automated Quality Measurement in Department of the Veterans Affairs Discharge Instructions for Patients with Congestive Heart Failure
Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures...
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| Veröffentlicht in: | Journal for healthcare quality 2013-07, Vol.35 (4), p.16-24 |
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| creator | Garvin, Jennifer H. Elkin, Peter L. Shen, Shuying Brown, Steven Trusko, Brett Wang, Enlai Hoke, Linda Quiaoit, Ylenia LaJoie, Joan Weiner, Mark G. Graham, Pauline Speroff, Theodore |
| description | Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures of quality of care were met for the completion of discharge instructions for inpatients with congestive heart failure. We used a single document, the discharge instructions, from one section of the medical records for 152 patients and developed a reference standard using two independent reviewers to assess performance. When evaluated against the reference standard, MCVS achieved a sensitivity of 0.87, a specificity of 0.86, and a positive predictive value of 0.90. The automated process using the discharge instruction document worked effectively. The use of the MCVS tool for concept‐based indexing resulted in mostly accurate data capture regarding quality measurement, but improvements are needed to further increase the accuracy of data extraction. |
| doi_str_mv | 10.1111/j.1945-1474.2011.195.x |
| format | Article |
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In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures of quality of care were met for the completion of discharge instructions for inpatients with congestive heart failure. We used a single document, the discharge instructions, from one section of the medical records for 152 patients and developed a reference standard using two independent reviewers to assess performance. When evaluated against the reference standard, MCVS achieved a sensitivity of 0.87, a specificity of 0.86, and a positive predictive value of 0.90. The automated process using the discharge instruction document worked effectively. The use of the MCVS tool for concept‐based indexing resulted in mostly accurate data capture regarding quality measurement, but improvements are needed to further increase the accuracy of data extraction.</description><identifier>ISSN: 1062-2551</identifier><identifier>EISSN: 1945-1474</identifier><identifier>DOI: 10.1111/j.1945-1474.2011.195.x</identifier><identifier>PMID: 23819743</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Automation ; evaluation of health information technology ; Health administration ; Heart failure ; Heart Failure - rehabilitation ; Hospitals, Veterans - standards ; Humans ; Medical Informatics Applications ; natural language processing (NLP) ; Outcome and Process Assessment (Health Care) - methods ; Patient Discharge - standards ; Patient Education as Topic - methods ; Patient Education as Topic - standards ; performance measurement ; Pilot Projects ; Quality Indicators, Health Care ; Systematized Nomenclature of Medicine ; United States ; United States Department of Veterans Affairs</subject><ispartof>Journal for healthcare quality, 2013-07, Vol.35 (4), p.16-24</ispartof><rights>2012 National Association for Healthcare Quality</rights><rights>2012 National Association for Healthcare Quality.</rights><rights>2013 National Association for Healthcare Quality</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3905-468dad4f3b4fd98dedc20d923598669ebeeb1272080ef97cec5826503f9e25b83</citedby><cites>FETCH-LOGICAL-c3905-468dad4f3b4fd98dedc20d923598669ebeeb1272080ef97cec5826503f9e25b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1945-1474.2011.195.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1945-1474.2011.195.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23819743$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garvin, Jennifer H.</creatorcontrib><creatorcontrib>Elkin, Peter L.</creatorcontrib><creatorcontrib>Shen, Shuying</creatorcontrib><creatorcontrib>Brown, Steven</creatorcontrib><creatorcontrib>Trusko, Brett</creatorcontrib><creatorcontrib>Wang, Enlai</creatorcontrib><creatorcontrib>Hoke, Linda</creatorcontrib><creatorcontrib>Quiaoit, Ylenia</creatorcontrib><creatorcontrib>LaJoie, Joan</creatorcontrib><creatorcontrib>Weiner, Mark G.</creatorcontrib><creatorcontrib>Graham, Pauline</creatorcontrib><creatorcontrib>Speroff, Theodore</creatorcontrib><title>Automated Quality Measurement in Department of the Veterans Affairs Discharge Instructions for Patients with Congestive Heart Failure</title><title>Journal for healthcare quality</title><addtitle>J Healthc Qual</addtitle><description>Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures of quality of care were met for the completion of discharge instructions for inpatients with congestive heart failure. We used a single document, the discharge instructions, from one section of the medical records for 152 patients and developed a reference standard using two independent reviewers to assess performance. When evaluated against the reference standard, MCVS achieved a sensitivity of 0.87, a specificity of 0.86, and a positive predictive value of 0.90. The automated process using the discharge instruction document worked effectively. The use of the MCVS tool for concept‐based indexing resulted in mostly accurate data capture regarding quality measurement, but improvements are needed to further increase the accuracy of data extraction.</description><subject>Automation</subject><subject>evaluation of health information technology</subject><subject>Health administration</subject><subject>Heart failure</subject><subject>Heart Failure - rehabilitation</subject><subject>Hospitals, Veterans - standards</subject><subject>Humans</subject><subject>Medical Informatics Applications</subject><subject>natural language processing (NLP)</subject><subject>Outcome and Process Assessment (Health Care) - methods</subject><subject>Patient Discharge - standards</subject><subject>Patient Education as Topic - methods</subject><subject>Patient Education as Topic - standards</subject><subject>performance measurement</subject><subject>Pilot Projects</subject><subject>Quality Indicators, Health Care</subject><subject>Systematized Nomenclature of Medicine</subject><subject>United States</subject><subject>United States Department of Veterans Affairs</subject><issn>1062-2551</issn><issn>1945-1474</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUc1O3DAYtCqqQmlfAVniwiVb_8ROzG21lC4VFUWCXi0n-cx6lcRb2ynsA_S96-1SDj3hi7-xZ-YbaRA6oWRG8_m0nlFVioKWVTljhNIMxezpDTp6eT7IM5GsYELQQ_Q-xjUheS6rd-iQ8ZqqquRH6Pd8Sn4wCTp8O5nepS3-BiZOAQYYE3YjvoCNCekv8hanFeAfkCCYMeK5tcaFiC9cbFcmPAC-GmMKU5ucz9_WB_zdJJelET-6tMILPz5ATO4X4CVkV3xpXJ93fUBvrekjfHy-j9H95ee7xbK4vvlytZhfFy1XRBSlrDvTlZY3pe1U3UHXMtIpxoWqpVTQADSUVYzUBKyqWmhFzaQg3Cpgoqn5MTrb-26C_znlJHrI0aHvzQh-ippyxSvFiZSZevofde2nMOZ0mlZEKlIRzjNL7llt8DEGsHoT3GDCVlOid0Xptd41oneN6F1RGQr9lIUnz_ZTM0D3IvvXTCac7wmProftK2311-VtHvgf9PqiWw</recordid><startdate>201307</startdate><enddate>201307</enddate><creator>Garvin, Jennifer H.</creator><creator>Elkin, Peter L.</creator><creator>Shen, Shuying</creator><creator>Brown, Steven</creator><creator>Trusko, Brett</creator><creator>Wang, Enlai</creator><creator>Hoke, Linda</creator><creator>Quiaoit, Ylenia</creator><creator>LaJoie, Joan</creator><creator>Weiner, Mark G.</creator><creator>Graham, Pauline</creator><creator>Speroff, Theodore</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201307</creationdate><title>Automated Quality Measurement in Department of the Veterans Affairs Discharge Instructions for Patients with Congestive Heart Failure</title><author>Garvin, Jennifer H. ; Elkin, Peter L. ; Shen, Shuying ; Brown, Steven ; Trusko, Brett ; Wang, Enlai ; Hoke, Linda ; Quiaoit, Ylenia ; LaJoie, Joan ; Weiner, Mark G. ; Graham, Pauline ; Speroff, Theodore</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3905-468dad4f3b4fd98dedc20d923598669ebeeb1272080ef97cec5826503f9e25b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Automation</topic><topic>evaluation of health information technology</topic><topic>Health administration</topic><topic>Heart failure</topic><topic>Heart Failure - rehabilitation</topic><topic>Hospitals, Veterans - standards</topic><topic>Humans</topic><topic>Medical Informatics Applications</topic><topic>natural language processing (NLP)</topic><topic>Outcome and Process Assessment (Health Care) - methods</topic><topic>Patient Discharge - standards</topic><topic>Patient Education as Topic - methods</topic><topic>Patient Education as Topic - standards</topic><topic>performance measurement</topic><topic>Pilot Projects</topic><topic>Quality Indicators, Health Care</topic><topic>Systematized Nomenclature of Medicine</topic><topic>United States</topic><topic>United States Department of Veterans Affairs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garvin, Jennifer H.</creatorcontrib><creatorcontrib>Elkin, Peter L.</creatorcontrib><creatorcontrib>Shen, Shuying</creatorcontrib><creatorcontrib>Brown, Steven</creatorcontrib><creatorcontrib>Trusko, Brett</creatorcontrib><creatorcontrib>Wang, Enlai</creatorcontrib><creatorcontrib>Hoke, Linda</creatorcontrib><creatorcontrib>Quiaoit, Ylenia</creatorcontrib><creatorcontrib>LaJoie, Joan</creatorcontrib><creatorcontrib>Weiner, Mark G.</creatorcontrib><creatorcontrib>Graham, Pauline</creatorcontrib><creatorcontrib>Speroff, Theodore</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal for healthcare quality</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garvin, Jennifer H.</au><au>Elkin, Peter L.</au><au>Shen, Shuying</au><au>Brown, Steven</au><au>Trusko, Brett</au><au>Wang, Enlai</au><au>Hoke, Linda</au><au>Quiaoit, Ylenia</au><au>LaJoie, Joan</au><au>Weiner, Mark G.</au><au>Graham, Pauline</au><au>Speroff, Theodore</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Automated Quality Measurement in Department of the Veterans Affairs Discharge Instructions for Patients with Congestive Heart Failure</atitle><jtitle>Journal for healthcare quality</jtitle><addtitle>J Healthc Qual</addtitle><date>2013-07</date><risdate>2013</risdate><volume>35</volume><issue>4</issue><spage>16</spage><epage>24</epage><pages>16-24</pages><issn>1062-2551</issn><eissn>1945-1474</eissn><abstract>Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). 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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Automation evaluation of health information technology Health administration Heart failure Heart Failure - rehabilitation Hospitals, Veterans - standards Humans Medical Informatics Applications natural language processing (NLP) Outcome and Process Assessment (Health Care) - methods Patient Discharge - standards Patient Education as Topic - methods Patient Education as Topic - standards performance measurement Pilot Projects Quality Indicators, Health Care Systematized Nomenclature of Medicine United States United States Department of Veterans Affairs |
| title | Automated Quality Measurement in Department of the Veterans Affairs Discharge Instructions for Patients with Congestive Heart Failure |
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