HIT Standards Committee HIT Standards Committee Report of the Clinical Quality Report of the Clinical Quality Workgroup Workgroup Janet Corrigan, Chair Floyd Eisenberg July 21, 2009
Jan 15, 2016
HIT Standards CommitteeHIT Standards Committee
Report of the Clinical Quality WorkgroupReport of the Clinical Quality Workgroup
Janet Corrigan, Chair
Floyd Eisenberg
July 21, 2009
Clinical Quality Workgroup --Process
• CQ Workgroup conference calls – June 22, 2009– July 15, 2009
• Consultation/Coordination with Policy Committee– July 9, 2009 (Meaningful Use Workgroup)– July 16, 2009 (Policy Committee)
CQ Workgroup Initial Tasks
• Identify potential set of existing standardized performance measures that correspond to the Policy Committee’s quality measure concepts
• Identify the “data types” that must be captured to calculate the measures
• Handoff to Clinical Operations Workgroup to identify HIT standards
Sources of Measures
• National Quality Forum (NQF) Database – Over 500 endorsed measures– Pipeline measures
• Includes measures used by Centers for Medicare & Medicaid (CMS) (in PQRI and RHQDAPU), Hospital Quality Alliance, accrediting entities, and Physician Consortium for Performance Improvement
Identify Data Types
Health Information Technology Expert Panel (HITEP)
– Convened by NQF; supported by Agency for Healthcare Research and Quality (AHRQ)
– Identify a “Quality Data Set”
– Types of data necessary to calculate and report on performance
– Currently includes over 56 “data types”
Performance Measure Set for 2011
• Includes 27 performance measures (see handout)
• Provisional recommendations– Detailed review of measures by CQ Workgroup not yet
complete– CO Workgroup identification of HIT standards not yet complete
• Significant measure “retooling” required– Efforts underway to ascertain feasibility
• Seeking Standards Committee approval with understanding that there will need to be some changes
Performance Measures: Key Challenges
• Measure Gaps – E.g., % reportable lab results; % patients with access to
educational resources– For 2011 attestation is likely method of data collection
• Available measures developed assuming more limited availability of data– Fail to take advantage of clinically-rich data in EHRs– E.g., % patients at high risk for cardiac events on aspirin
prophylaxis
Performance Measures: Key Challenges
• Some measures rely on data types that will be challenging to capture in 2011 – E.g., BMI, vital signs– May be necessary to have different measure specifications for
2011 and 2013 (e.g., ICD-9 for 2011 and SNOMED for 2013)
• Some measures require data for which there is currently no standardized method of collecting– E.g., VTE (antithrombotic devices)
Performance Measures: Key Challenges
• Some measures require data that may be costly to collect– Lipid profile
• Significant harmonization issues– Measures should be patient-centered– Current measures vary across settings (e.g.,
hospital, ambulatory, LTC) and age groups (e.g., BMI measure for children differs from BMI for adults)
Next Steps
• Detailed review of individual measures underway– Identify any necessary changes in measures – Provide guidance to measure stewards regarding “retooling”
• Develop a 2-dimensinal framework for classifying measures– Degree of readiness of a measure for 2011 implementation– Level of performance expectations (i.e., threshold
considerations)