Date

February 2012

Document Type

Thesis

Degree Name

M.S.

Department

Dept. of Medical Informatics and Clinical Epidemiology

Institution

Oregon Health & Science University

Abstract

Objective: To assess the impact of a Breast Imaging Results And Data System (BI-RADS) and electronic health record (EHR) interface on the quality of mammogram results data stored in an EHR database. Setting: Ambulatory internal medicine faculty practice affiliated with a large academic community hospital. Methods: The quality of mammogram result entries in an EHR for women between 40-65 years of age during a fifteen-month period prior to the creation of a BI-RADS-EHR interface and fifteen months after inception of the interface was analyzed. Using a list of mammogram result terms as a standard, the data quality was rated as high, medium, or low. A high-quality entry required the use of a correctly spelled standard term. Medium-quality entries used a correctly spelled abbreviated or non-standard term and low quality entries were either misspelled, blank, or correctly spelled terms not related to mammography. For null entries in the post-interface period, it was determined whether the woman had a mammogram at our facility and if she had, radiology registration data were analyzed to determine whether the primary care physician had been identified correctly. Results: There were 843 entries during the pre-interface period and 861 entries during the post-interface period. High quality entries were present in 350 (41.6%) and 552 (63.8%), medium quality in 4 (0.5%) and 1 (0.1%), low quality in 488 (58.0%) and 308 (35.8%) entries during the pre-interface and post-interface periods, respectively. Blank entries decreased from 468 (55.5%) to 308 (35.8%) after creation of the interface. In the post-interface period, in 90 of 308 (29.2%) of the blank entries, the patient had had a mammogram performed at our facility; in 100% of these 90 entries, the mammogram had been ordered by a provider from another practice. In these instances, either no primary care provider or an incorrect primary care provider was identified at the time of registration in the radiology department. Conclusions: A BIRADS-EHR interface significantly improved the quality of mammogram result entries in an electronic health record with high reliability. However, radiology registration processes ultimately determine whether a result is interfaced to a primary care physician. Assuring high quality mammogram result data in EHRs requires attention to both technical and process details.

Identifier

doi:10.6083/M4610X97

School

School of Medicine

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