EMRs offer an attractive method for evaluating guideline implementation and improving quality of care. This study, led by Dr. Victor Stevens (KPNW), developed a method for coding tobacco-cessation activities (the “Five A’s”) in four HMOs using EMRs. Data were obtained from coded fields, and information entered in free-text fields (e.g., progress notes) was coded using MediClass, a natural language processing program. The team evaluated the accuracy of MediClass in assessing whether clinicians adhered to the national tobacco treatment guidelines (the “Five A’s”) with patients. MediClass performed as well as the human abstractors and was found to be practical for assessing primary care adherence to the tobacco treatment guidelines.
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