Is the meaningful use venous thromboembolism vte-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases

Norma E. Farrow, Brandyn Lau, Eric A. Johnbull, Deborah B. Hobson, Peggy S. Kraus, Elizabeth R. Taffe, Dauryne L. Shaffer, Victor O. Popoola, Michael B Streiff, Peter J. Pronovost, Elliott Haut

Research output: Contribution to journalArticle

Abstract

Background: Venous thromboembolism (VTE) is a common, often deadly cause of preventable harm for hospitalized patients. The Centers for Medicare & Medicaid Services Meaningful Use VTE-6 measure automatically captures data documented in a Meaningful Use-certified electronic health record (EHR) to identify patients with potentially preventable VTE, defined as those who developed radiologically confirmed, in-hospital VTE and did not receive prophylaxis between admission and the day prior to the diagnostic test order date. The validity of the Meaningful Use VTE-6 measure was assessed by reviewing the quality of VTE prophylaxis provided to patients identified by the measure. Methods: A retrospective chart review was performed on all patients identified by VTE-6 during the first year of Meaningful Use Stage 1. The following information was abstracted from the Meaningful Use-certified EHR: patient demographics, clinical data, VTE prophylaxis prescribed and administered, and diagnostic testing. These data were then analyzed to assess prevention efforts prior to each VTE event and identify potential targets for improvement. Results: Fifteen patients were identified as having sustained potentially preventable VTE by the Meaningful Use VTE-6 measure. Nine (60%) of the 15 patients identified were false positives and did not meet the rationale of the measure. For only 6 (40%) of the 15 patients was VTE considered to be truly potentially preventable; those patients provided targets for quality improvement measures. Conclusions: The majority of patients identified by the Meaningful Use VTE-6 algorithm did not suffer truly potentially preventable VTE. Misclassification of VTE as "potentially preventable" hinders efforts to target true opportunities for quality improvement.

Original languageEnglish (US)
Pages (from-to)410-416
Number of pages7
JournalJoint Commission Journal on Quality and Patient Safety
Volume42
Issue number9
StatePublished - Sep 1 2016

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Venous Thromboembolism
Electronic Health Records
Quality Improvement
Patient Harm
Medicaid
Medicare
Routine Diagnostic Tests

ASJC Scopus subject areas

  • Medicine(all)

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Is the meaningful use venous thromboembolism vte-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases. / Farrow, Norma E.; Lau, Brandyn; Johnbull, Eric A.; Hobson, Deborah B.; Kraus, Peggy S.; Taffe, Elizabeth R.; Shaffer, Dauryne L.; Popoola, Victor O.; Streiff, Michael B; Pronovost, Peter J.; Haut, Elliott.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 42, No. 9, 01.09.2016, p. 410-416.

Research output: Contribution to journalArticle

Farrow, NE, Lau, B, Johnbull, EA, Hobson, DB, Kraus, PS, Taffe, ER, Shaffer, DL, Popoola, VO, Streiff, MB, Pronovost, PJ & Haut, E 2016, 'Is the meaningful use venous thromboembolism vte-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases', Joint Commission Journal on Quality and Patient Safety, vol. 42, no. 9, pp. 410-416.
Farrow, Norma E. ; Lau, Brandyn ; Johnbull, Eric A. ; Hobson, Deborah B. ; Kraus, Peggy S. ; Taffe, Elizabeth R. ; Shaffer, Dauryne L. ; Popoola, Victor O. ; Streiff, Michael B ; Pronovost, Peter J. ; Haut, Elliott. / Is the meaningful use venous thromboembolism vte-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases. In: Joint Commission Journal on Quality and Patient Safety. 2016 ; Vol. 42, No. 9. pp. 410-416.
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abstract = "Background: Venous thromboembolism (VTE) is a common, often deadly cause of preventable harm for hospitalized patients. The Centers for Medicare & Medicaid Services Meaningful Use VTE-6 measure automatically captures data documented in a Meaningful Use-certified electronic health record (EHR) to identify patients with potentially preventable VTE, defined as those who developed radiologically confirmed, in-hospital VTE and did not receive prophylaxis between admission and the day prior to the diagnostic test order date. The validity of the Meaningful Use VTE-6 measure was assessed by reviewing the quality of VTE prophylaxis provided to patients identified by the measure. Methods: A retrospective chart review was performed on all patients identified by VTE-6 during the first year of Meaningful Use Stage 1. The following information was abstracted from the Meaningful Use-certified EHR: patient demographics, clinical data, VTE prophylaxis prescribed and administered, and diagnostic testing. These data were then analyzed to assess prevention efforts prior to each VTE event and identify potential targets for improvement. Results: Fifteen patients were identified as having sustained potentially preventable VTE by the Meaningful Use VTE-6 measure. Nine (60{\%}) of the 15 patients identified were false positives and did not meet the rationale of the measure. For only 6 (40{\%}) of the 15 patients was VTE considered to be truly potentially preventable; those patients provided targets for quality improvement measures. Conclusions: The majority of patients identified by the Meaningful Use VTE-6 algorithm did not suffer truly potentially preventable VTE. Misclassification of VTE as {"}potentially preventable{"} hinders efforts to target true opportunities for quality improvement.",
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AU - Lau, Brandyn

AU - Johnbull, Eric A.

AU - Hobson, Deborah B.

AU - Kraus, Peggy S.

AU - Taffe, Elizabeth R.

AU - Shaffer, Dauryne L.

AU - Popoola, Victor O.

AU - Streiff, Michael B

AU - Pronovost, Peter J.

AU - Haut, Elliott

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N2 - Background: Venous thromboembolism (VTE) is a common, often deadly cause of preventable harm for hospitalized patients. The Centers for Medicare & Medicaid Services Meaningful Use VTE-6 measure automatically captures data documented in a Meaningful Use-certified electronic health record (EHR) to identify patients with potentially preventable VTE, defined as those who developed radiologically confirmed, in-hospital VTE and did not receive prophylaxis between admission and the day prior to the diagnostic test order date. The validity of the Meaningful Use VTE-6 measure was assessed by reviewing the quality of VTE prophylaxis provided to patients identified by the measure. Methods: A retrospective chart review was performed on all patients identified by VTE-6 during the first year of Meaningful Use Stage 1. The following information was abstracted from the Meaningful Use-certified EHR: patient demographics, clinical data, VTE prophylaxis prescribed and administered, and diagnostic testing. These data were then analyzed to assess prevention efforts prior to each VTE event and identify potential targets for improvement. Results: Fifteen patients were identified as having sustained potentially preventable VTE by the Meaningful Use VTE-6 measure. Nine (60%) of the 15 patients identified were false positives and did not meet the rationale of the measure. For only 6 (40%) of the 15 patients was VTE considered to be truly potentially preventable; those patients provided targets for quality improvement measures. Conclusions: The majority of patients identified by the Meaningful Use VTE-6 algorithm did not suffer truly potentially preventable VTE. Misclassification of VTE as "potentially preventable" hinders efforts to target true opportunities for quality improvement.

AB - Background: Venous thromboembolism (VTE) is a common, often deadly cause of preventable harm for hospitalized patients. The Centers for Medicare & Medicaid Services Meaningful Use VTE-6 measure automatically captures data documented in a Meaningful Use-certified electronic health record (EHR) to identify patients with potentially preventable VTE, defined as those who developed radiologically confirmed, in-hospital VTE and did not receive prophylaxis between admission and the day prior to the diagnostic test order date. The validity of the Meaningful Use VTE-6 measure was assessed by reviewing the quality of VTE prophylaxis provided to patients identified by the measure. Methods: A retrospective chart review was performed on all patients identified by VTE-6 during the first year of Meaningful Use Stage 1. The following information was abstracted from the Meaningful Use-certified EHR: patient demographics, clinical data, VTE prophylaxis prescribed and administered, and diagnostic testing. These data were then analyzed to assess prevention efforts prior to each VTE event and identify potential targets for improvement. Results: Fifteen patients were identified as having sustained potentially preventable VTE by the Meaningful Use VTE-6 measure. Nine (60%) of the 15 patients identified were false positives and did not meet the rationale of the measure. For only 6 (40%) of the 15 patients was VTE considered to be truly potentially preventable; those patients provided targets for quality improvement measures. Conclusions: The majority of patients identified by the Meaningful Use VTE-6 algorithm did not suffer truly potentially preventable VTE. Misclassification of VTE as "potentially preventable" hinders efforts to target true opportunities for quality improvement.

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