Editor's Correspondence |

Beware the Burden of Measurement—Reply

Stephen D. Persell, MD, MPH; Jason A. Thompson, BA; Karen S. Kmetik, PhD; David W. Baker, MD, MPH
Arch Intern Med. 2007;167(9):972. doi:10.1001/archinte.167.9.972.
Text Size: A A A
Published online


In reply

We agree with Sinsky that clinicians should not be burdened with documenting clinical information solely for the purpose of quality measurement for external reporting. However, collecting standardized data in electronic health records (EHRs) can also be used to improve quality and safety within a practice. Clear examples are computerized clinical decision support for drug-allergy, drug-drug, or drug-condition interactions. In addition, better structured data will improve physician alerts and feedback indicating when important quality goals are not met for preventive services and therapies for patients with chronic disease, such as coronary heart disease. Better decision support becomes possible with better data. Unstructured data cannot be used for practice-wide assessment and improvement. Which of the 5000 patients does not have up-to-date breast, colon, or cervical cancer screening? Who has medical reasons for which the test is not indicated? If the answers to these questions are stored as standardized data rather than being lost in a sea of free text, a practice can systematically notify patients who may benefit from a service and avoid those who have already received it or have a medical reason not to do it.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics