Research to Reform: Are we making progress? Measuring the adoption, meaningful use, and impacts of health IT (Text Version)

On September 15, 2009, Floyd Eisenberg made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (781 KB). 

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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.

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Quality and Information Technology

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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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HITEP (Health Information Technology Expert Panel)

Primary content experts
   Study designers.
   Guideline developers.

Concept Diabetes.

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Primary content experts - Measure Developers

Code list - 250.xx
Concept - diabetes

Can be reused with multiple quality datatypes.

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Primary content experts - Measure Developers

QDS element

Code list - 250.xx
Concept - diabetes
Data type - active

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Primary content experts - Measure Developers

Stored in database for reuse across measures and decision support.

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Primary content experts - Measure Developers

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Primary content experts - Measure Developers

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Primary content experts - Measure Developers

Includes measure-
Specific dataflow (e.g. EHR vs. PHR).

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Primary content experts - Measure Developers

Measure
EHR, HIE, registry

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Primary content experts - Measure Developers

EHR, HIE, registry

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Primary content experts - Measure Developers

EHR, HIE, registry
EHR
Registries

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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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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.
Diabetes AND Coronary Artery Disease AND / OR Moderately or Severely Depressed Left Ventricular Systolic Function.

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Progress

HIT Standards Committee

1. 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.

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HL7 Standard Development

Health Quality Measure Format (HQMF): eMeasure
    eMeasure Style Sheet (Human Readable)

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

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Connecting the Dots