AHCPR Releases New Clinical Performance Measures Database

Press Release Date: April 3, 1996

The Agency for Health Care Policy and Research today released a landmark computer tool that will make it easier for health plans, providers, and purchasers to choose and use clinical performance measures to assess the quality of the services they provide and purchase.

CONQUEST 1.0, the COmputerized Needs-Oriented QUality Measurement Evaluation SysTem, summarizes information on approximately 1200 clinical performance measures developed by public and private sector organizations to examine the quality of clinical care. Because measures are described using a common language, CONQUEST 1.0 will enable users to identify existing measures, compare among them, and select measures most appropriate to their needs.

"CONQUEST will be an indispensable tool for clinicians, purchasers, and health plans as they increasingly face pressure to demonstrate that the services they provide and purchase are of the highest quality and offer the best value," said AHCPR Administrator Clifton Gaus, ScD. Gaus added, "CONQUEST will provide them with one-stop-shopping for the most appropriate and cost-effective clinical performance measures to meet their needs."

CONQUEST is the only tool of its kind that is available publicly. It links clinical conditions to measures through two interlocking databases—a Condition Database and a Measure Database—which allow users to target specific conditions or measures. CONQUEST includes pre-programmed reports on measures and conditions and also allows users to perform tailored searches and create customized reports. Users can enter additional measures and conditions of interest to them if these are not already in the databases. CONQUEST also will help identify where new measures are needed.

The Condition Database currently contains information on 52 clinical conditions, representing those identified as prevalent by major health surveys and the most costly diagnoses for Medicare and Medicaid. In addition, CONQUEST 1.0 also summarizes recommendations from AHCPR-sponsored clinical practice guidelines, findings from AHCPR's Patient Outcomes Research Team (PORT) projects, and other key research. As a result, the guidelines and research can guide the user in selecting the most appropriate measures for their specific needs.

To date, the Measure Database contains 53 measure sets developed by AHCPR, HCFA, the Department of Veterans Affairs, and other federal organizations; accrediting organizations such as the National Committee for Quality Assurance, and the Joint Commission on the Accreditation of Healthcare Organizations; associations such as the Maryland Hospital Association and the American Group Practice Association; private sector organizations such as United Health Care and the Pacific Area Business Group on Health, and research organizations such as Harvard and RAND.

In addition to information on the performance measures themselves, CONQUEST gives the user the ability to examine the clinical rationale behind a given performance measure as well as the methodological assumptions, data source requirements, sampling requirements, the clinical setting for which the measure was designed, and methods for "scoring" or analyzing a given measure, and it provides information on how to obtain measure specifications.

CONQUEST 1.0 also is a tool for learning about performance measures, learning how to evaluate and select measures for a given purpose, and learning how to identify and link performance measures that are clinically related. Specifically, the Condition Database provides information on common clinical conditions, their prevalence, and their impact on health costs and the health of populations, as well as co-morbidities, risk factors, and potentially preventable conditions. With this information, the user can search in the Measure Database for performance indicators related to services and outcomes for a given condition.

CONQUEST was developed with AHCPR funding under a contract with Mikalix & Company of Waltham, MA and its subcontractor, the Center for Quality of Care Research and Education at the Harvard University School of Public Health. Public- and private-sector organizations, such as health plans, purchasers, and clinicians, who need state-of-the-art information clinical performance measures can get a copy from AHCPR's Publications Clearinghouse or from AHCPR's Web site at https://www.ahrq.gov/qual/

Methodological guidance and leadership for the development of CONQUEST were provided by R. Heather Palmer, MB, BCh, SM, Director, Center for Quality of Care Research & Education, Harvard University School of Public Health and Dr. Ann Lawthers.

According to Dr. Palmer, "CONQUEST will be an R&D shortcut for organizations looking for performance measurement information. Instead of reinventing the wheel, they will be able to see what their colleagues have done, compare it to what they are doing, and make their decisions accordingly." Dr. Palmer added, "CONQUEST 1.0 is dynamic and will continue to evolve to meet the needs of the health care industry."

CONQUEST 1.0 builds on AHCPR's Measurement Typology project to collect, review, and analyze performance measures used by the public and private sector to examine quality of care. Phase I of this project, released in March 1995, resulted in the two-volume AHCPR report Understanding and Choosing Clinical Performance Measures for Quality Improvement: Development of a Typology.

The system, which AHCPR is making available for widespread testing and use, has been designed in Microsoft® Access®. This month AHCPR will begin a preliminary project to user test CONQUEST 1.0. The project, which is being jointly funded by AHCPR and the Robert Wood Johnson Foundation, will bring together a geographically, professionally, and clinically diverse group of about 30 participants to evaluate the user-friendliness of the tool as well as to identify clinical performance measurement needs and the potential of CONQUEST to meet those needs.

A limited supply of CONQUEST 1.0 materials including a diskette containing the databases, overview of the final report, and user's guide will be available from the AHCPR Publications Clearinghouse. Call 800-358-9295 and request AHCPR Publication No. 96-N009. CONQUEST 1.0 materials also will be available from the National Technical Information Service later this year. Use the following order numbers:

CONQUEST diskette, user's guide, and final report overview: PB96-501655 $90.00
user's guide: PB96-140777 $44.50
final report: PB96-140785 $27.00
validation report: PB96-140793 $27.00

CONQUEST 1.0 Databases and the User's Guide are available as FTP files on AHCPR's site on the World Wide Web. The databases have been created in Microsoft® Access® but may be usable with other database software. The user's guide and final report are in WordPerfect™ versions 6.0 and greater. The appendices are in WordPerfect™ 6.1. The address is: https://www.ahrq.gov/qual/conquest.htm.

For additional information, contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855 ; or Salina Prasad, (301) 427-1864.