Quality assessment and lipid management: considerations for computer databases for tracking patients

Improving the quality of lipid management requires an objective assessment of current practice and the ability to monitor whether quality is improved by implementing changes in practice. In a competitive healthcare environment, documentation of quality of care and patient outcomes may be important in securing contracts. It would be almost impossible to perform a meaningful clinical-outcome analysis in a timely fashion without the support of a computerized database. However, evaluating, selecting, and implementing computerized databases can be a daunting task. Before the purchase of a database, the following steps should be performed: (1) consider and prioritize the goals for the computerized database; (2) audit charts to determine whether the existing chart format meets the current guidelines for reimbursement and medical–legal standards; (3) revise the paper chart to improve fulfillment of the goals from step 1; (4) consider the specific clinical environment, including the skill level of personnel using the system, how user-friendly the system is, whether the system is multifunctional, and the costs associated with the software and implementation. We have evaluated 3 types of computerized databases and report their strengths and weaknesses; we also briefly discuss the electronic medical record.