A new NQF report provides guidance for assessing the quality of the building blocks of electronic clinical quality measures (eMeasures). There are more than 70,000 of these building blocks, called value sets, which provide definitions for data elements, e.g., diagnosis of diabetes, needed to calculate eMeasures under the federal Meaningful Use program and other national reporting initiatives. Many of these building blocks overlap with other, similar value sets, making eMeasures created from them difficult to compare. This lack of standardization undermines quality improvement efforts.
“NQF’s work to streamline eMeasures is very important as the nation shifts toward interoperable electronic health records,” said Michael Lieberman, MD, MS, chief health information officer, Oregon Health and Science University, and co-chair of NQF’s Value Set Harmonization Committee. “Value sets need to be further standardized so that eMeasures are easier to implement and maintain. This work will help ensure better developed measures and improvements in measurement, for better care and outcomes for patients.”
Concluding that a one-size-fits-all harmonization approach for value sets would be difficult to create and implement, the report instead recommends developing guidance for managing value set versions and developing a process to identify and label value sets as expired (and indicate that newer versions exist) to help reduce duplicate or redundant value sets.
The report also recommends that NQF, for the short term, oversee the review of high quality and harmonized value sets as part of its consensus development process for quality measures. However, the report suggests that groups outside of NQF continue to develop and evaluate value sets.
NQF’s project was guided by a multistakeholder committee with experts from across the measure development, health IT, and informatics sectors with significant experience in both the development and use of value sets in eMeasures and data sets in EHRs, as well as a technical expert panel of providers, consultants, measure developers, and informatics specialists who were responsible for piloting activities recommended by the committee.
To date, NQF has endorsed eMeasures in the areas of mental health, diabetes, cancer, cardiovascular care, and medication management.