slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Background PowerPoint Presentation
Download Presentation
Background

Loading in 2 Seconds...

play fullscreen
1 / 10

Background - PowerPoint PPT Presentation


  • 134 Views
  • Uploaded on

Using the AHRQ National Quality Measures Clearinghouse to Assess Diabetes Quality Measurement Brian Leas, MS, MA University of Pennsylvania Health System AHRQ Annual Conference September 19, 2011. Background. Research Objectives

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Background' - jalia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Using the AHRQ National Quality Measures Clearinghouse to Assess Diabetes Quality MeasurementBrian Leas, MS, MAUniversity of Pennsylvania Health SystemAHRQ Annual ConferenceSeptember 19, 2011

background
Background
  • Research Objectives
  • Evaluate the state of diabetes quality measurement, utilization & impact
  • Determine key strengths, weaknesses, gaps
  • Develop strategies to enhance value and impact of diabetes measures
  • Research Team
  • Thomas Jefferson University School of Population Health

David Nash, Principal Investigator Kathryn Kash, Qualitative Interviewer

Neil Goldfarb, Co-Investigator Rich Toner, Research Coordinator

Al Crawford, Measurement Analyst Brian Leas, Project Manager

Bettina Berman, Measurement Analyst

  • Timeline: Spring 2008 – Summer 2009
  • Funding
  • National Changing Diabetes Program of Novo Nordisk
methodology
Methodology
  • Environmental scan of diabetes quality measures
    • Measure developers: Accreditation agencies, payers, physician groups, QI organizations, state/local initiatives
    • All types of measures: Process, outcome, safety, etc.
    • Specifications: Definitions, inclusion/exclusion, time frame
    • Scope: Broadly representative of key sectors, rather than fully comprehensive
  • Key informant interviews
    • Measure developers, physicians, payers, employers, QI orgs
    • Representation from all relevant stakeholder groups
    • Interviewees expert in both technical development and practical utilization of quality measures
    • Semi-structured, recorded
search strategy
Search Strategy
  • Step 1: National Quality Measures Clearinghouse (NQMC)
    • Keywords: “diabetes” and “diabetes mellitus”
    • 98 measures identified
  • Step 2: Supplemental search
    • Roster compiled of key organizations & known measure sets
    • Reviewed websites, contacted organizations for information
    • 48 additional measures identified
  • Step 3: Data abstracted into Excel spreadsheet
measure abstraction
Measure Abstraction
  • Descriptive characteristics
    • Brief description
    • Clinical topic (e.g. HgbA1c mgmt, lipid profile, foot exam)
    • Developer
    • Release and revision dates
    • Broader measurement set
    • Website link
    • NQMC identification #
  • Specifications
    • Level of measurement (e.g. clinician, health plan)
    • Source of data (e.g. administrative, medical record, pharmacy, lab, registry)
    • Numerator / denominator
    • Inclusion / exclusion
    • Time frame
measure abstraction1
Measure Abstraction
  • Validity
    • Supporting evidence
    • Extent of measure testing
    • Composition of development group
    • Endorsement by NQF and others
  • Policy-relevant domains*
    • AHRQ: Process, outcome, access, structure, use of services, patient experience, population health
    • IOM: Effectiveness, efficiency, equity, patient-centeredness, safety, timeliness

*Dimensions as of 2008

key informant interviews
Key Informant Interviews

Measure utilization and value

  • Blue Cross Blue Shield Association
  • Centers for Disease Control and Prevention
  • Institute for Healthcare Improvement
  • America’s Health Insurance Plans
  • American Academy of Family Physicians
  • Nat’l Business Coalition on Health
  • American Diabetes Association
  • American Association of Clinical Endocrinologists
  • American Association of Diabetes Educators

Measure development, selection, endorsement

  • National Committee for Quality Assurance
  • National Quality Forum
  • American Medical Association
  • Centers for Medicare and Medicaid Services
  • Ambulatory Quality Alliance
  • Pharmacy Quality Alliance
  • American Board of Medical Specialties
  • American Board of Internal Medicine
  • American College of Physicians
  • Wisconsin Collaborative for

Healthcare Quality

findings
Findings
  • Scope of Measurement
      • Nearly 150 measures in > 25 distinct clinical categories
      • Primarily process measures
      • Substantial redundancy
      • Widely varying specifications
      • Evidence base often weak or unclear
  • Measurement Gaps
      • Primary prevention
      • Outcomes of care
      • Patient perspectives
      • Coordination of care
      • Access to care
perspectives on nqmc
Perspectives on NQMC
  • Highly useful for identifying relevant measures
    • Although 1/3 of measures in our study had not been included in NQMC, many were later submitted by their respective authors
    • Sufficiently specific and sensitive
    • Capability to stratify by numerous categories
    • Only known resource for identifying and comparing measure sets from different sources
  • Limitations
    • Time lag from development to submission to posting
    • Relies on self-reporting
    • Until recently, limited data available on evidence base, validity, conflicts of interest
questions
Questions?

Brian Leas

Research Analyst

Center for Evidence-based Practice

University of Pennsylvania Health System

Brian.leas@uphs.upenn.edu