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Purpose: Meaningful use criteria are a set of metrics medical providers must comply with by 2015 to indicate the electronic medical record is being utilized as an effective tool. Included in these metrics is anticoagulation overlap therapy (VTE-3). This metric assesses the number of patients with a confirmed venous thromboembolism (VTE) who receive appropriate five day overlap therapy with a parenteral anticoagulant and warfarin. By 2015, hospitals should demonstrate an 80% compliance rate. The purpose of this study is to determine rates of compliance with VTE-3 at two hospitals within an academic medical center and evaluate the accuracy of computer software utilized within the medical center to assess rates of compliance with VTE-3.
Methods: Electronic medical records for 817 patients with an ICD-9 code for VTE diagnosis admitted to the medical center between March 1, 2011 and August 31, 2011 were reviewed for compliance with VTE-3. Rates of metric compliance were based on total number of confirmed VTE cases and the number of cases meeting the quality metric.
Results: A total of 111 patients, at the two hospitals, were identified as having a confirmed VTE with an overall compliance rate of 72% with VTE-3. Less than five days of overlap therapy was the most common reason (71%) for non-compliance with VTE-3. During the three month period of data captured by computer software, the rate of compliance was 48% compared to 76% by manual data collection.
Conclusion: An 80% rate of compliance was not demonstrated during the six months of data collection. Furthermore, the computer software designed to capture metric data was not as accurate as manual data collection. It remains questionable as to how computer software will be utilized to document compliance with VTE-3. The many complexities of anticoagulation therapy management could adversely affect rates of compliance detected by computer software.