Impact of Electronic Medical Record Intervention on OP-29 and OP-30 Scores at St. Lukeʼs University Health Network

Abstract

Introduction: The Centers for Medicare and Medicaid Services (CMS) Hospital Outpatient Quality Reporting Program (HOQR) is a program that utilizes data collected from various methods to promote more efficient and higher quality healthcare for Medicare beneficiaries. This study will focus on the two quality measures OP-29 and OP-30 at St. Luke's University Health Network. OP-29 examines the appropriate follow up interval for normal colonoscopy in average risk patients and OP-30 examines colonoscopy interval for patients with a history of adenomatous polyps<./p> In October 2017, St. Luke's Health Network implemented additional quality documentation into our electronic medical record (EMR) that allowed providers to efficiently enter the purpose of the colonoscopy, the time interval since the patient's last colonoscopy, the patient's medical history regarding colon polyps and colon cancer, and when the next colonoscopy was indicated. The goal of this study is to examine if these electronic interventions have resulted in improved OP-29 and OP-30 scores across our health network. Methods: This study examines data obtained from St. Luke's Health Network starting on January 1, 2017 and ending on May 31, 2018. OP-29 and OP-30 scores were calculated for St. Luke's regional campuses each month during the study through an analysis of EMR colonoscopy procedure charts based on screening criteria outlined by CMS. Results: Since the EMR intervention in October 2017, OP-29 scores have improved on average by 5% and OP-30 scores have increased 12% on average. Each month in 2018 except January 2018 has shown a positive improvement for OP-29 data over the prior year and all months in 2018 have shown a positive improvement for OP-30 data over the prior year. For both 2017 and 2018, the average OP-29 scores at St. Luke's Health Network exceeded the 2016 national average. In 2018, the average OP-30 score at St. Luke's Health Network exceeded the 2016 national average. Conclusion: The decline in OP-29 scores during the month of January 2018 was a result of the EMR upgrade that month which temporarily hindered provider input and additional education about the EMR intervention was provided to our endoscopists in January 2018. Excluding January's 2018 data results in an OP-29 score improvement of 9% overall following EMR intervention.1083_A Figure 1. OP-29 Score Trend at St. Luke's University Health Network1083_B Figure 2. OP-30 Score Trend at St.Luke's University Health Network1083_C Figure 3. Percent Improvement for OP-29 and OP-30 Scores at St. Luke's University Health Network in 2018 compared with 2017