--- title: "Leverage EHRs to measure care processes. | Sutter Health" description: "To assess the reliability of data in EHRs for measuring processes of care among PCPs and examine relationship of these measures and clinical outcomes." url: "https://www.sutterhealth.org/research/publications/leverage-ehrs-to-measure-care-processes-1055312664" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Leverage EHRs to measure care processes. # Leveraging electronic health records to develop measurements for processes of care. Tai-Seale M, Wilson CJ, Panattoni L, Kohli N, Stone A, Hung DY, & Chung S. _Health Serv Res. 49(2):628-44. doi: 10.1111/1475-6773.12126. Epub 2013 Nov 18._ 2014-04-01 ## Abstract OBJECTIVES: To assess the reliability of data in electronic health records (EHRs) for measuring processes of care among primary care physicians (PCPs) and examine the relationship between these measures and clinical outcomes. DATA SOURCES/STUDY SETTING: EHR data from 15,370 patients with diabetes, 49,561 with hypertension, in a group practice serving four Northern California counties. STUDY DESIGN/METHODS: Exploratory factor analysis (EFA) and multilevel analysis of the relationships between processes of care variables and factor scales with control of hemoglobin A1c, blood pressure (BP), and low density lipoprotein (LDL) among patients with diabetes and BP among patients with hypertension. PRINCIPAL FINDINGS: Volume of e-messages, number of days to the third-next-available appointment, and team communication emerged as reliable factors of PCP processes of care in EFA (Cronbach's alpha=0.73, 0.62, and 0.91). Volume of e-messages was associated with higher odds of LDL control (≤100) (OR=1.13, p<.05) among patients with diabetes. Frequent in-person visits were associated with better BP (OR=1.02, p<.01) and LDL control (OR=1.01, p<.01) among patients with diabetes, and better BP control (OR=1.04, p<.01) among patients with hypertension. CONCLUSIONS: The EHR offers process of care measures which can augment patient-reported measures of patient-centeredness. Two of them are significantly associated with clinical outcomes. Future research should examine their association with additional outcomes. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/24236994) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Implementation of departmental quality strategies is positively associated with clinical practice: results of a multicenter study in 73 hospitals in 7 European countries.](https://www.sutterhealth.org/research/publications/quality-strategies-assoc-clinical-practrace-1055312466) Sunol R, Wagner C, Arah OA, Kristensen S, Pfaff H, Klazinga N, Thompson CA, Wang A, DerSarkissian M, Bartels P, Michel P, Groene O; DUQuE Project Consortium. 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Am J Manag Care. 26(4):e127-e134. doi: 10.37765/ajmc.2020.42840. 2020 Apr 01 - Publication ### [The electronic health record audit file: the patient is waiting.](https://www.sutterhealth.org/research/publications/ehr-audit-file-patient-wait-times-1055312785) Hirsch AG, Jones JB, Lerch VR, Tang X, Berger A, Clark DN, Stewart WF. J Am Med Inform Assoc. 2017 Apr 1;24(e1):e28-e34. doi: 10.1093/jamia/ocw088. 2017 Apr 01 - Publication ### [Issues in the design of Internet-based systems for collecting patient-reported outcomes.](https://www.sutterhealth.org/research/publications/internet-based-systems-to-collect-patient-reported-outcomes-1055312761) Jones JB, Snyder CF, Wu AW. Qual Life Res. 16(8):1407-17. Epub 2007 Aug 1. 2007 Oct 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/leverage-ehrs-to-measure-care-processes-1055312664#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Leverage EHRs to measure care processes."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/leverage-ehrs-to-measure-care-processes-1055312664#medicalscholarlyarticle","name":"Leveraging electronic health records to develop measurements for processes of care.","headline":"Leverage EHRs to measure care processes.","abstract":"OBJECTIVES: To assess the reliability of data in electronic health records (EHRs) for measuring processes of care among primary care physicians (PCPs) and examine the relationship between these measures and clinical outcomes. DATA SOURCES/STUDY SETTING: EHR data from 15,370 patients with diabetes, 49,561 with hypertension, in a group practice serving four Northern California counties. STUDY DESIGN/METHODS: Exploratory factor analysis (EFA) and multilevel analysis of the relationships between processes of care variables and factor scales with control of hemoglobin A1c, blood pressure (BP), and low density lipoprotein (LDL) among patients with diabetes and BP among patients with hypertension. PRINCIPAL FINDINGS: Volume of e-messages, number of days to the third-next-available appointment, and team communication emerged as reliable factors of PCP processes of care in EFA (Cronbach's alpha=0.73, 0.62, and 0.91). Volume of e-messages was associated with higher odds of LDL control (≤100) (OR=1.13, p\u003c.05) among patients with diabetes. Frequent in-person visits were associated with better BP (OR=1.02, p\u003c.01) and LDL control (OR=1.01, p\u003c.01) among patients with diabetes, and better BP control (OR=1.04, p\u003c.01) among patients with hypertension. CONCLUSIONS: The EHR offers process of care measures which can augment patient-reported measures of patient-centeredness. Two of them are significantly associated with clinical outcomes. 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