Health Information Technology Expert Panel

Purpose

To convene an expert panel to develop a set of common data elements and healthcare workflow changes to enable automation of performance measures through electronic health records (EHRs) and health information exchange.

Background

In its March 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine (IOM) linked automated information management as a fundamental need to achieve a healthcare system that is re-centered to focus on the patient. Likewise, the healthcare quality community has long recognized that such electronic information systems are a critical factor to provide data for measures of healthcare quality. To date, the vast majority of available electronic data has been claims data, which has consequently been used to measure quality. However, while recent initiatives such as the Ambulatory Quality Alliance (AQA) and Hospital Quality Alliance (HQA) have specified measures that can be populated with such readily-available administrative data, performance can be more accurately characterized when clinical data is used.

The American Health Information Community (AHIC), a FACA advisory committee to the Secretary of Health and Human Services (HHS), established a Quality Workgroup to define how health information technology (HIT) can effectively support quality improvement. The workgroup ultimately recommended that the Quality Alliance Steering Committee (QASC), with support from HHS and other relevant federal agencies, convene an expert panel to accelerate ongoing efforts in this arena. NQF has been commissioned to assemble and convene said expert panel.

Scope and Process

A panel of approximately 20 experts in electronic healthcare information systems and 8-10 federal agency representatives was convened on May 31, 2007 and September 24, 2007 to do the following:

identify a set of common data elements to be standardized to enable automation of AQA and HQA measures through electronic health records and health information exchange;
establish a priority order for existing AQA and HQA measures;
gather, synthesize, and refine clinical workflow maps, focusing on care processes related to the conditions targeted by the prioritized set of measures;
determine mechanisms within the workflows to: 1) identify patients who are eligible for inclusion in the measure populations, 2) gather performance measurement data, and 3) provide clinical decision support to optimize performance in targeted areas;
develop a generic framework that could be used across many clinical conditions; and
develop at least one scenario for how the workflows will operate for AQA and HQA targeted conditions.

The project did not utilize the NQF Consensus Development Process (CDP) per se, as it did not result in voluntary consensus standards. Project deliverables included a publicly available final report summarizing the data element and performance measure prioritization criteria and process, a prioritized list of all current and proposed AQA and HQA measures, and a starter group of measures with specified data elements.

NQF will ultimately incorporate the panel’s recommendations into existing endorsement criteria to reinforce the use of the selected data elements to allow quality measures to be effectively embedded in EHRs.
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Funding

Support for this project has been provided by the Agency for Healthcare Research and Quality (AHRQ). For more information, contact Daniel Rosenthal at 202.783.1300 or via email at info@qualityforum.org