North Carolina medical journal
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The North Carolina Immunization Registry (NCIR) has been available since 2004. We sought to measure its utilization among practices that provide primary care for children who are enrolled in a prospective influenza surveillance study. ⋯ More than 95% of children younger than 6 years of age had 2 or more immunizations documented in the NCIR; thus, the Centers for Disease Control and Prevention 2010 goal for immunization information systems was met in this population. We found substantial agreement between practice records and the NCIR for influenza and pneumococcal immunizations in children.
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Clinical quality measurement remains an elusive goal, and it has the potential to result in adverse outcomes and unexpected consequences. Practicing physicians are wary of current efforts but should remain professionally committed to the development of effective, evidence-based quality measures.
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The Improving Performance in Practice program of the South East Area Health Education Center aims to assist primary care practices in using electronic health records to improve outcomes for patients with chronic diseases. This commentary describes the challenges and successes of practices that have participated in this program.
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Community Care of North Carolina's provider-driven approach to quality improvement has benefitted tens of thousands of North Carolinians with diabetes, asthma, hypertension, heart failure, and cardiovascular disease, and it has achieved better results than commercial Medicaid managed care nationally. Substantial opportunities remain, however, particularly for patients with complex care needs.
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Asthma is a prevalent, morbid, and costly chronic condition that may result in preventable exacerbations requiring emergency department (ED) care. In North Carolina we have limited information about the frequency and characteristics of asthma-related ED visits. ⋯ We have characterized the burden of asthma in EDs across North Carolina, by county and among key subpopulations. These data can be used to target and evaluate local and statewide asthma-control policy efforts.