Medical care
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Although there is considerable interest in underutilization of lipid testing, little is known about the prevalence and factors associated with overtesting of serum lipids. ⋯ Multiple lipid testing is associated with the presence of multiple providers, independent of indications for testing, comorbidity, and total physician visits. Much of the association of multiple lipid testing with medical expenditures at the level of HRR appears to be explained by differences in exposure to multiple providers.
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Electronic health record (EHR) systems have the potential to revolutionize quality improvement (QI) methods by enhancing quality measurement and integrating multiple proven QI strategies. ⋯ Implementation of a multifaceted QI intervention using EHR tools to improve quality measurement and the accuracy and timeliness of clinician feedback improved performance and/or accelerated the rate of improvement for multiple measures simultaneously.
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Performance reporting is increasingly focused on physician practice sites and individual physicians. ⋯ In a multipayer collaborative, sample sizes were adequate to reliably assess clinical process and outcome measures at the practice site level. For individual physicians, sample sizes proved adequate to reliably measure preventive care, but may not be feasible for chronic care assessment.