www.qualityforum.org research to reform: are we making progress? measuring the adoption, meaningful...
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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
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Quality and Information Technology
F7
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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
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concept
diabetes
HITEP (Health Information Technology Expert Panel
Primary content experts
• study designers
• guideline developers
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code list
concept
can be reused with multiple quality datatypes
diabetes
250.xx
Primary content experts Measure Developers
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data type
code list
concept
QDS element
diabetes
250.xx
active
Primary content experts Measure Developers
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stored in database for reuse across measures and decision
support
QDS database
data type
code list
concept
Primary content experts Measure Developers
www.qualityforum.orgmeasure
EHR
data flow
prob list
code list
data type
concept
diabetes
250.xx
active
Primary content experts Measure Developers
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data flow
code list
data type
concept
Primary content experts Measure Developers
www.qualityforum.orgmeasure
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
Primary content experts Measure Developers
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data flow
code list
data type
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data flow
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data type
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data flow
code list
data type
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data flow
code list
data type
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data flow
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data type
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Primary content experts Measure Developers EHR, HIE, registry
www.qualityforum.orgmeasure
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
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data flow
code list
data type
concept
Primary content experts Measure Developers EHR, HIE, registry
www.qualityforum.orgmeasure
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
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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
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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