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Fam Pract. 2016 Dec;33(6):639-643. Epub 2016 Jul 28.

The validation of electronic health records in accurately identifying patients eligible for colorectal cancer screening in safety net clinics.

Author information

1
The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, amanda.f.petrik@kpchr.org.
2
Group Health Research Institute, Seattle, WA and.
3
The Center for Health Research, Kaiser Permanente Northwest, Portland, OR.
4
OCHIN, Portland, OR, USA.

Abstract

BACKGROUND:

While electronic health records (EHRs) play a key role in increasing colorectal cancer (CRC) screening by identifying individuals who are overdue, important shortfalls remain.

OBJECTIVES:

As part of the Strategies and Opportunities to STOP Colon Cancer (STOP CRC) study, we assessed the accuracy of EHR codes in identifying patients eligible for CRC screening.

METHODS:

We selected a stratified random sample of 800 study participants from 26 participating clinics, in the Pacific Northwest region of the USA. We compared data obtained through codes in the EHR to conduct a manual chart audit. A trained chart abstractor completed the abstraction of eligible and ineligible patients.

RESULTS:

Of 520 individuals in need of CRC screening, identified via the EHR, 459 were confirmed through chart review (positive predictive value = 88%). Of 280 individuals flagged as up-to-date in their screening per EHR data, 269 were confirmed through chart review (negative predictive value = 96%). Among the 61 patients incorrectly classified as eligible, 83.6% of disagreements were due to evidence of a prior colonoscopy or referral that was not captured in recognizable fields in the EHR.

CONCLUSIONS:

Our findings highlight importance of better capture of past screening events in the EHR. While the need for better population-based data is not unique to CRC screening, it provides an important example of the use of population-based data not only for tracking care, but also for delivering interventions.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01742065.

KEYWORDS:

Colorectal cancer; community medicine; electronic health record; gastroenterology; screening.

PMID:
27471224
PMCID:
PMC5161488
DOI:
10.1093/fampra/cmw065
[Indexed for MEDLINE]
Free PMC Article

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