Quality of hospital electronic health record (EHR) data based on the international consortium for health outcomes measurement (ICHOM) in heart failure: pilot data quality assessment study

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• dc.contributor.author Aerts, Hannelore
• dc.contributor.author Kalra, Dipak
• dc.contributor.author Sáez, Carlos
• dc.contributor.author Ramírez Anguita, Juan Manuel
• dc.contributor.author Mayer, Miguel Ángel, 1960-
• dc.contributor.author García-Gómez, Juan M.
• dc.contributor.author Durà-Hernández, Marta
• dc.contributor.author Thienpont, Geert
• dc.contributor.author Coorevits, Pascal
• dc.date.accessioned 2022-06-17T06:36:28Z
• dc.date.available 2022-06-17T06:36:28Z
• dc.date.issued 2021
• dc.description.abstract Background: There is increasing recognition that health care providers need to focus attention, and be judged against, the impact they have on the health outcomes experienced by patients. The measurement of health outcomes as a routine part of clinical documentation is probably the only scalable way of collecting outcomes evidence, since secondary data collection is expensive and error-prone. However, there is uncertainty about whether routinely collected clinical data within electronic health record (EHR) systems includes the data most relevant to measuring and comparing outcomes and if those items are collected to a good enough data quality to be relied upon for outcomes assessment, since several studies have pointed out significant issues regarding EHR data availability and quality. Objective: In this paper, we first describe a practical approach to data quality assessment of health outcomes, based on a literature review of existing frameworks for quality assessment of health data and multistakeholder consultation. Adopting this approach, we performed a pilot study on a subset of 21 International Consortium for Health Outcomes Measurement (ICHOM) outcomes data items from patients with congestive heart failure. Methods: All available registries compatible with the diagnosis of heart failure within an EHR data repository of a general hospital (142,345 visits and 12,503 patients) were extracted and mapped to the ICHOM format. We focused our pilot assessment on 5 commonly used data quality dimensions: completeness, correctness, consistency, uniqueness, and temporal stability. Results: We found high scores (>95%) for the consistency, completeness, and uniqueness dimensions. Temporal stability analyses showed some changes over time in the reported use of medication to treat heart failure, as well as in the recording of past medical conditions. Finally, the investigation of data correctness suggested several issues concerning the characterization of missing data values. Many of these issues appear to be introduced while mapping the IMASIS-2 relational database contents to the ICHOM format, as the latter requires a level of detail that is not explicitly available in the coded data of an EHR. Conclusions: Overall, results of this pilot study revealed good data quality for the subset of heart failure outcomes collected at the Hospital del Mar. Nevertheless, some important data errors were identified that were caused by fundamentally different data collection practices in routine clinical care versus research, for which the ICHOM standard set was originally developed. To truly examine to what extent hospitals today are able to routinely collect the evidence of their success in achieving good health outcomes, future research would benefit from performing more extensive data quality assessments, including all data items from the ICHOM standards set and across multiple hospitals.
• dc.description.sponsorship MAM and JMRA had support from the Innovative Medicines Initiative Joint Under-taking under EMIF grant agreement no. 115372, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies. The funders were not involved in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
• dc.format.mimetype application/pdf
• dc.identifier.citation Aerts H, Kalra D, Sáez C, Ramírez-Anguita JM, Mayer MA, Garcia-Gomez JM, et al. Quality of hospital electronic health record (EHR) data based on the international consortium for health outcomes measurement (ICHOM) in heart failure: pilot data quality assessment study. JMIR Med Inform. 2021 Aug 4; 9(8): e27842. DOI: 10.2196/27842
• dc.identifier.doi http://dx.doi.org/10.2196/27842
• dc.identifier.issn 2291-9694
• dc.identifier.uri http://hdl.handle.net/10230/53517
• dc.language.iso eng
• dc.publisher JMIR Publications
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/115372
• dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on https://medinform.jmir.org/, as well as this copyright and license information must be included.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Data quality
• dc.subject.keyword Electronic health records
• dc.subject.keyword Heart failure
• dc.subject.keyword Patient outcome assessment
• dc.subject.keyword Value-based health insurance
• dc.title Quality of hospital electronic health record (EHR) data based on the international consortium for health outcomes measurement (ICHOM) in heart failure: pilot data quality assessment study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion