NQF webinar maps the route to quality improvement

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Standardizing performance measures, with the help of health IT, will make it possible to collect the right data at the right time to support performance measurement, clinical decision support, clinical research and quality improvement, said Janet M. Corrigan, PhD, president and CEO of the National Quality Forum (NQF) during a webinar hosted by the forum on June 17. Currently, “There are a lot of efforts underway,” she noted.

The webinar focused on quality improvement and the role of health IT as outlined by the speakers, who summarized the link between meaningful use, EHR incentives and performance measures and the NQF’s health IT portfolio and its role in bridging the quality and health IT communities.

Corrigan presented a supply chain of quality activities currently underway for the NQF, beginning with the establishment of national priorities and goals. “You can’t measure and improve everything at once, so we want to identify those high leverage areas,” she explained, noting that these priorities are slated to be delivered to Congress in January 2011.

The quality data set is now out for public comment, and Corrigan noted that the NQF is seeking input on how the data set has evolved, “It is a work in progress, and will continue to evolve in the coming years,” she said.

Movement towards meaningful use
Marc Overhage, MD, PhD, director of medical informatics at the Regenstrief Institute in Indianapolis, explained that “the goal of the HITECH Act is to improve patient care.”

Overhage laid out a meaningful use timeline:

  • 2011 will establish the initial set of meaningful use rules will focus on data capturing and sharing;
  • 2013 will focus on advanced clinical processes, including more clinical decision support; and
  • 2015 should see improved patient outcomes.

Overhage noted that each year from 2011 to 2015 will see more incentive payments to providers to increase the number of meaningful users. He also described a correlation between national priorities and meaningful use, noting that EHR utilization can improve public health and enhance care coordination by facilitating the exchange of clinical information, medication reconciliation and a summary of care record.

The current state of NQF
NQF is currently helping to build the e-infrastructure for quality improvement with the help of others in the measurement and IT community, said Floyd Eisenberg, MD, senior vice president of health IT for NQF.

The quality community has struggled to locate the clinical information needed to determination high quality performance, noted Eisenberg.  “Before, all we had available was claims or lab data,” he noted, and explained that the quality data set provides a link between performance measurement and health IT. The data set provides a foundation for electronic quality measures that facilitate communication between the quality community and EHR technology.

According to Eisenberg, quality data set benefits include:

  • Decreased cost for measure development, maintenance and revision;
  • A common language for measurement and reporting;
  • Reduced healthcare reporting burden for providers; and
  • Access to standard information in EHRs.

Currently, the NQF is building the quality data set model. “We are in the process of looking at 110 existing measures and taking the data that is requested by those measures and re-identifying that data in the EHR rather than a claim,” he offered. “We are locating measurable components of the EHR, determining effective use of those measures and identifying unintended consequences that might occur using those data elements.”

Einsenberg concluded with the lessons learned thus far in linking health IT with quality improvement. “In looking at the measure, think outside the claims box. It's very easy to look at a current measure in a claim, but think about where that data really is present in the EHR and where it can be moved to capture that data,” he explained.  

Noting the formation of a new health IT user group which will include vendors, health plans and providers, Einsenberg encouraged participation from the audience. “Basically our approach is to connect the dots between measurement and moving upstream to decision support and further upstream, the clinical guideline information, all around the same infrastructure.”