TY - JOUR
T1 - Making audit actionable: an example algorithm for blood pressure management in chronic kidney disease.
AU - Brown, Benjamin
AU - Williams, Richard
AU - Sperrin, Matthew
AU - Frank, Timothy
AU - Ainsworth, John
AU - Buchan, Iain
PY - 2014/1
Y1 - 2014/1
N2 - Despite widespread use of clinical guidelines, actual care often falls short of ideal standards. Electronic health records (EHR) can be analyzed to provide information on how to improve care, but this is seldom done in sufficient detail to guide specific action. We developed an algorithm to provide practical, actionable information for care quality improvement using blood pressure (BP) management in chronic kidney disease (CKD) as an exemplar. We used UK clinical guidelines and EHR data from 440 patients in Salford (UK) to develop the algorithm. We then applied it to 532,409 individual patient records, identifying 11,097 CKD patients, 3,766 (34{\%}) of which showed room for improvement in their care: either through medication optimization or better BP monitoring. Manual record reviews to evaluate accuracy indicated a positive-predictive value of 90{\%}. Such algorithms could help improve the management of chronic conditions by providing the missing link between clinical audit and decision support.
AB - Despite widespread use of clinical guidelines, actual care often falls short of ideal standards. Electronic health records (EHR) can be analyzed to provide information on how to improve care, but this is seldom done in sufficient detail to guide specific action. We developed an algorithm to provide practical, actionable information for care quality improvement using blood pressure (BP) management in chronic kidney disease (CKD) as an exemplar. We used UK clinical guidelines and EHR data from 440 patients in Salford (UK) to develop the algorithm. We then applied it to 532,409 individual patient records, identifying 11,097 CKD patients, 3,766 (34{\%}) of which showed room for improvement in their care: either through medication optimization or better BP monitoring. Manual record reviews to evaluate accuracy indicated a positive-predictive value of 90{\%}. Such algorithms could help improve the management of chronic conditions by providing the missing link between clinical audit and decision support.
M3 - Article
C2 - 25954337
SN - 1942-597X
VL - 2014
SP - 343
EP - 352
JO - AMIA Annual Symposium. Proceedings
JF - AMIA Annual Symposium. Proceedings
ER -
