结构中的问题,一致性,电子健康记录数据的完整性是结果研究的障碍,质量改进,并进行重新设计。这项非实验性回顾性研究检查了将去识别的电子健康记录数据导入外部系统以识别患有原发性高血压并有风险的患者的实用性。我们发现,与单独的诊断编码(平均值=1,174.5,95%CI1,150.5-1,198.3)相比,联合使用诊断和自由文本编码(平均值=1,256.1,95%CI1,232.3-1,279.7)的病例在统计学上显着增加。虽然在扩大搜索标准时识别出明显更多的患者并不奇怪,这对护理质量至关重要,向国家质量保证委员会的以患者为中心的医疗之家计划的运动,以及有意义地使用电子健康记录。Further,我们发现,根据最近两个或两个以上血压读数大于或等于140/90mmHg(平均值=1,353.9,95%CI1,329.9-1,377.9),潜在病例有统计学显著增加.
Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance\'s Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).