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Quality and Information Technology

Research to Reform: Are we making progress? Measuring the adoption, meaningful use, and impacts of health IT September 15, 2009 Floyd Eisenberg, MD, MPH, FACP Senior Vice President, Health Information Technology feisenberg@qualityforum.org National Quality Forum. F7.

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Quality and Information Technology

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  1. Research to Reform:Are we making progress? Measuring the adoption, meaningful use, and impacts of health IT September 15, 2009 Floyd Eisenberg, MD, MPH, FACP Senior Vice President, Health Information Technology feisenberg@qualityforum.org National Quality Forum

  2. F7 Quality and Information Technology

  3. 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

  4. concept diabetes HITEP (Health Information Technology Expert Panel Primary content experts • study designers • guideline developers

  5. code list concept Primary content experts Measure Developers 250.xx diabetes can be reused with multiple quality datatypes

  6. code list concept data type Primary content experts Measure Developers QDS element 250.xx diabetes active

  7. code list QDS database concept data type stored in database for reuse across measures and decision support Primary content experts Measure Developers

  8. code list data flow concept data type EHR measure Primary content experts Measure Developers 250.xx prob list diabetes active

  9. code list data flow concept data type Primary content experts Measure Developers measure

  10. measure database QDS database code list code list code list code list code list data flow data flow data flow data flow data flow concept concept concept concept concept data type data type data type data type data type Primary content experts Measure Developers includes measure- specific dataflow (e.g. EHR vs. PHR) measure

  11. code list code list code list code list code list data flow data flow data flow data flow data flow concept concept concept concept concept data type data type data type data type data type Primary content experts Measure Developers EHR, HIE, registry measure

  12. code list code list code list code list code list data flow data flow data flow data flow data flow concept concept concept concept concept data type data type data type data type data type measure Primary content experts Measure Developers EHR, HIE, registry

  13. code list code list code list code list code list data flow data flow data flow data flow data flow concept concept concept concept concept data type data type data type data type data type measure Primary content experts Measure Developers HER, HIE, registry EHR Registries

  14. Structure » Active Project – 26 Measures CMS HITSP Project – Spring 2009 • Standardize specifications for three (3) inpatient measure sets: • Venous Thromboembolism (VTE - 8) • Stroke (STK – 6) • Emergency Department (ED – 2) • Physician Quality Reporting Initiative (PQRI) Ambulatory Measures (PQRI – 10) • Demonstration • Certification

  15. Structure » Quality Data Set Build Measures From Individual QDS Elements: Adding Logic ACE I Prescription OR ARB Prescription - ACE I Allergy + ARB Allergy - Med Reason - Etc Coronary Artery Disease AND Diabetes AND / OR Moderately or Severely Depressed Left Ventricular Systolic Function

  16. Progress HIT Standards Committee • 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 • Retooling beginning September 21, 2009 • Review measure submission workflow

  17. HL7 Standard Development Health Quality Measure Format (HQMF): eMeasure eMeasure Style Sheet (Human Readable) http://www.hl7.org/v3ballot/html/domains/uvqm/uvqm.htm

  18. Clinical Guidelines Decision Support Quality Measures Connecting the Dots

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