quality and information technology

www.qualityforum.org

Research to Reform:

Are we making progress? Measuring the adoption, meaningful use, and impacts of health ITSeptember 15, 2009

Floyd Eisenberg, MD, MPH, FACPSenior Vice President, Health Information [email protected] Quality Forum


2

Quality and Information Technology

F7


Structure » Quality Measure

• A “well-defined quality measure” is

• composed of a set of common data elements,

• encoded using standard taxonomies,

• structured logically into a standardized expression

• that can be shared and applied to patient data and reported

3


concept

diabetes

HITEP (Health Information Technology Expert Panel

Primary content experts

• study designers

• guideline developers


code list

concept

can be reused with multiple quality datatypes

diabetes

250.xx

Primary content experts Measure Developers


data type

code list

concept

QDS element

diabetes

250.xx

active



stored in database for reuse across measures and decision

support

QDS database

data type

code list

concept


www.qualityforum.orgmeasure

EHR

data flow

prob list

code list

data type

concept

diabetes

250.xx

active



data flow

code list

data type

concept



data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

includes measure-specific dataflow (e.g. EHR vs. PHR)

measure databas

e

data flow

code list

data type

concept

QDS databas

e



data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

Primary content experts Measure Developers EHR, HIE, registry


data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

data flow

code list

data type

concept

EHR

Registries

Primary content experts Measure Developers HER, HIE, registry


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Structure » Active Project – 26 Measures

CMS HITSP Project – Spring 2009

Standardize specifications for three (3) inpatient measure sets:

1. Venous Thromboembolism (VTE - 8)

2. Stroke (STK – 6)

3. Emergency Department (ED – 2)

4. Physician Quality Reporting Initiative (PQRI) Ambulatory Measures (PQRI – 10)

5. Demonstration

6. Certification


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DiabetesCoronary

Artery Disease

Moderately or Severely Depressed Left

Ventricular Systolic Function

ACE I PrescriptionARB PrescriptionACE I AllergyARB Allergy+OR -

AND

AN

D /

OR

Med ReasonEtc--

Build Measures From Individual QDS Elements:

Adding Logic

Structure » Quality Data Set


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Progress1. Update to measure grid for meaningful use– Recommended set of 29 measures– 17 can be retooled for EHRs– Other measures

• 10 EHR utilization• 2 Privacy and Security

2. Retooling beginning September 21, 2009

3. Review measure submission workflow

HIT Standards Committee


Health Quality Measure Format (HQMF): eMeasure

http://www.hl7.org/v3ballot/html/domains/uvqm/uvqm.htm

eMeasure Style Sheet (Human Readable)

HL7 Standard Development


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Connecting the Dots

Clinical Guidelines

Decision Support

Quality Measures

quality and information technology

Documents