Assessing the quality of epilepsy care with an electronic patient record

PURPOSE The American Academy of Neurology (AAN) quality indicators for epilepsy are designed to monitor quality, identify gaps, and ultimately drive improvements in clinical care. Appreciation of electronic patient records (EPR) to support such performance management is growing. This study aimed to demonstrate the use of an epilepsy-specific EPR in applying the AAN measures to objectively monitor clinical performance. METHOD A sample of out-patient clinics at Beaumont Hospital, Dublin was benchmarked against 4 of the AAN quality indicators. RESULTS 88% (142/160) of clinical encounters met the requirement to explicitly document seizure type and seizure frequency at each visit; aetiology or epilepsy syndrome was documented/updated for 58% (93/160); evidence of counselling about antiepileptic drug side effects was present in 34% (54/160) of records; counselling for women of childbearing potential was documented in 33% (18/57) of relevant records. CONCLUSION The EPR makes performance monitoring efficient and objective. Results suggest either failure to carryout recommended clinical tasks or poor documentation. Whichever is the case, a baseline is provided against which improvement goals can be set.