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Previous reviews of research on electronic health record (EHR) data quality have not focused on the needs of quality measurement. The authors reviewed empirical studies of EHR data quality, published from January 2004, with an emphasis on data attributes relevant to quality measurement. Many of the 35 studies reviewed examined multiple aspects of data quality. Sixty-six percent evaluated data accuracy, 57% data completeness, and 23% data comparability. The diversity in data element, study setting, population, health condition, and EHR system studied within this body of literature made drawing specific conclusions regarding EHR data quality challenging. Future research should focus on the quality of data from specific EHR components and important data attributes for quality measurement such as granularity, timeliness, and comparability. Finally, factors associated with poor or variability in data quality need to be better understood and effective interventions developed.

This report examines issues surrounding the establishment of a national patient outcomes database that would be used by patients and providers to make more informed treatment decisions. It focuses on prostate cancer and surgery for osteoarthritis. The authors conclude that such longitudinal databases would be both desirable and feasible but would require substantial resources

Using data from the 2006 Medical Expenditure Panel Survey and the 2000 Census, the authors explored whether race/ethnic disparities in health care use were associated with residential segregation. They used five measures of health care use: office-based physician visits, outpatient department physician visits, visits to nurses and physician's assistants, visits to other health professionals, and having a usual source of care. For each individual, the authors controlled for age, gender, marital status, insurance status, income, educational attainment, employment status, region, and health status. The authors used the racial–ethnic composition of the zip code to control for residential segregation. The findings suggest that disparities in health care utilization are related to both individuals' racial and ethnic identity and the racial and ethnic composition of their communities. Therefore, efforts to improve access to health care services and to eliminate health care disparities for African Americans and Hispanics should not only focus on individual-level factors but also include community-level factors.

Health care overuse contributes to unnecessary expenditures and patient exposure to harm. Understanding and addressing this problem requires a comprehensive set of valid metrics. This article describes and critiques the current state of overuse measurement through a review of the published and gray literature, measures clearinghouses and ongoing work by major measure developers. Our review identified 37 fully specified measures and 123 measurement development opportunities. Many services were considered overuse due to the extension of diagnostic or screening services to low-risk populations. There were more diagnostic or therapeutic overuse measures than for screening or monitoring/surveillance. Imaging services is a major focus of current measures, but opportunities exist to expand overuse measurement in medication, laboratory services. Future development of overuse measures would benefit from new empirical research and clinical guidelines focused on identifying indications or populations for which there is likely to be no or low benefit.