Automated extraction of Quality Oncology Practice Initiative (QOPI) quality measures from the Veterans Health Administration (VHA) electronic health record system.

e16560 Background: ASCO's QOPI is a program that requires manual data abstraction of medical record data to measure quality of cancer care, a necessary component of quality improvement programs. Improving quality of care for veterans is a long-standing goal of the VHA. The VHA's electronic health record (EHR) is a fully integrated health information system used in all VA healthcare settings. It is unknown whether automated data extraction from the VHA EHR is feasible to assess quality of cancer care. METHODS: Using non-small cell lung cancer (NSCLC) as an example, we examined the quality measure data elements needed to assess the fall 2010 QOPI measures. We then determined which data elements could be electronically collated from the VHA EHR. To complement and improve upon this method, we designed and implemented a note template in the VHA EHR at the Durham VA Medical Center. This template allows the oncologist to enter at the time of care delivery those required data elements not currently electronically retrievable from the EHR in a structured format suitable for automated retrieval. RESULTS: Based on data currently in the EHR not including data in the note template, data elements for 7/25 (28%) core measures, 7/9 (78%) symptom/toxicity management measures, 9/16 (56%) end-of-life measures and 0/9 (0%) NSCLC QOPI measures can be obtained automatically. Combined with data from the note template, data elements for 16/25 (64%) Core measures, 9/9 (100%) symptom/toxicity management measures, 14/16 (88%) end-of-life measures and 100% (9/9) NSCLC QOPI measures are able to be obtained electronically. CONCLUSIONS: A majority of data required to assess adherence with QOPI measures are readily available in the VHA EHR, particularly for measures common for all cancers. A note template is useful for structuring and capturing electronic data for cancer-specific measures. A comparison of manually abstracted data from the Fall 2010 QOPI data collection to electronically captured data will be available by June 2011. Embedding quality measures into the VHA's EHR system will allow real time quality assessment and improvement in cancer care.

Duke Scholars

Author Michael John Kelley Medicine, Medical Oncology