Increasing the use of quality measurement as part of electronic health records systems is critical to achieving meaningful use of health information technology, the American College of Physicians reported in a paper released Thursday at the 129,000-member organization's annual meeting in Toronto.

More than 5,000 health professionals are in attendance at the meeting, which runs to Saturday at the Metro Toronto Convention Centre.

The ACP paper, titled "EHR-Based Quality Measurement and Reporting – Critical for Meaningful Use and Health Care Improvement," asserts that using EHRs as the basis for quality measurement systems would allow for a more complete reflection of care processes and patient outcomes. Ultimately, this would result in a more clinically useful set of quality data.

"Physician practices face significant financial and workflow barriers to EHR adoption," said ACP President Joseph W. Stubbs, MD. "With the promise that could come from better quality measurement, it is critical that we provide physicians with the support necessary to acquire these systems."

In order to take full advantage of the benefits that EHRs could offer, the ACP recommends:

1. The primary purpose of EHR-based quality measurement and reporting should be to facilitate higher-quality, cost-effective healthcare.
2. In order for an EHR-based quality measurement and reporting program to engage all healthcare stakeholders, it must use clinically relevant measures and be accurate and trusted by a full range of stakeholders, particularly patients, physicians, and other healthcare providers.
3. Data to support EHR-based quality measurement and reporting should rely upon information routinely collected during the course of providing clinical care, including relevant data supplied by patients.
4. EHR-based quality measurement should begin with the goal of facilitating the real-time collection of data that support the effective use of point-of-care clinical decision support algorithms.
5. EHR-based quality measurement and reporting must not increase administrative work and/or impose uncompensated financial costs upon physicians and other healthcare providers, healthcare organizations, or patients.
6. Data elements that comprise quality measure data sets should be defined in a standard way to enable health IT developers to implement them effectively.
7. ACP supports the commitment of the HIT Standards Committee, the National Quality Forum (NQF), the NQF Health Information Technology Expert Panel (HITEP), Health Information Technology Standards Panel (HITSP), and others to develop unified standards for structured, codified data elements, calculation logic, measure structure and reporting structure for quality measures. The development of these standards requires concerted and consistent input from all healthcare stakeholders.

"Physicians using EHRs for effective quality measurement face significant implementation barriers. The challenge to making this happen is ensuring that EHRs are capable of reporting clinical outcomes and measures, and that physician offices have the necessary financial and workforce resources," said Stubbs. "However, the benefits that improved quality measurement could have for patient care would be tremendous."