June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Accuracy of electronic health records for systemic risk factors of ophthalmology patients
Author Affiliations & Notes
  • Aiyin Chen
    Oregon Health & Science University, Portland, Oregon, United States
  • Claudine Yee
    Oregon Health & Science University, Portland, Oregon, United States
  • Michelle Hribar
    Oregon Health & Science University, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Aiyin Chen, None; Claudine Yee, None; Michelle Hribar, None
  • Footnotes
    Support  Supported by grants R00LM12238, R01LM013426, 1R21EY031443, and P30EY10572 from the National Institutes of Health (Bethesda, MD) and by unrestricted departmental funding from Research to Prevent Blindness (New York, NY).
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1020. doi:
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    • Get Citation

      Aiyin Chen, Claudine Yee, Michelle Hribar; Accuracy of electronic health records for systemic risk factors of ophthalmology patients. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1020.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Systemic conditions such as hypertension (HTN) is a risk factor for ocular diseases. Electronic health records (EHRs) contain extensive data on systemic conditions that can help identify risk factors for eye disease, but the quality of EHR data is unclear. This project assesses the readiness of EHRs for large scale ophthalmic epidemiology research by examining data accuracy in EHRs of an ophthalmology practice for providing a definitive diagnosis of HTN.

Methods : Retrospective chart review of randomly selected cataract surgery patients at Oregon Health & Science University (OHSU) was conducted in OHSU’s EHR (Epic) and a combined EHR database outside our institution (Care Everywhere). Charts were reviewed for evidence of a primary care provider (PCP) at OHSU, while progress notes, problem lists, and medication lists were examined for evidence of a HTN diagnosis. Diagnosis of HTN was established when HTN was documented in any progress note or problem list, and anti-HTN medications appeared in medication list. The absence of HTN was established when there was no documentation of HTN and anti-HTN medications. Cases that did not fit into either category were deemed uncertain. Documentation in medication lists was compared for consistency between our institution’s EHR and outside EHRs.

Results : Of 134 patients reviewed, 69 (51%) had a PCP at OHSU, and 65 (48%) did not. Further, 87 patients (65%) had a certain diagnosis of HTN, 37(28%) did not have HTN, and 10(7%) were uncertain. There was no difference in frequency of uncertain cases between patients who had PCPs at OHSU vs those at outside institutions (P = 0.52). Patients were more likely to have an accurate HTN diagnosis in the problem list if they had OHSU PCPs (81%) than those without (61%; P = 0.01). Discrepancies between anti-HTN medications listed in the OHSU EHR and outside EHRs were present in 32% of patients; of these, 56% had PCPs at OHSU and 44% had outside PCPs (P = 0.25).

Conclusions : EHRs provide a valid diagnosis of HTN in most cases. Accuracy of the HTN diagnosis, particularly in problem lists, increases when the patient’s PCP is affiliated with the same institution. Inconsistencies exist in documentation of medications across different EHRs. Analysis of EHR data reliability is necessary before conducting large scale ophthalmic research.

This is a 2021 ARVO Annual Meeting abstract.


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