David M. Lang, MD, is professor of medicine and chair, Department of Allergy and Clinical Immunology, at the Cleveland Clinic. He also teaches evidence-based medicine at the Cleveland Clinic Lerner College of Medicine, and recently completed a four-year term on the Board of the American Academy of Allergy, Asthma, and Immunology (AAAAI). NQF spoke with David about using healthcare data and measurement for quality improvement.
NQF: How is the Cleveland Clinic using big data to improve healthcare?
DL: The Cleveland Clinic was an early adopter of electronic health records (EHRs). Currently, more than six million patients use our EHR system. We believe that transparency is an essential component of quality. All departments measure quality and report data about care outcomes, procedures, mortality rates, complications, and innovations on an annual basis. Current efforts are focused on enhancing collaboration among providers and establishing consistent protocols and metrics throughout our system to provide higher quality care for patients at a lower cost.
NQF: How is quality measurement at the forefront of the Cleveland Clinic’s work and at AAAAI?
DL: Quality measurement is very important to the Cleveland Clinic, because it informs our decisions about performance gaps and helps us identify interventions that improve patients’ outcomes. Without measurement, we would not know whether an intervention is making a difference.
Measurement is very important for AAAAI members, too. This focus led to the development of a new tool, the AAAAI Qualified Clinical Data Registry (QCDR), which was approved by the Centers for Medicare & Medicaid Services in 2014. In addition to helping AAAAI members satisfy Physician Quality Reporting System requirements, we anticipate the registry will help clinicians improve quality of care via access to tools and interventions, as well as peer-to-peer comparisons.
NQF: What role do you see quality measurement playing in years to come?
DL: Quality measurement will be increasingly important as our nation moves toward a healthcare system based on value, rather than volume. It is likely that quality measures will evolve from process measures to outcome measures that include functional status. There will be increased emphasis on patient-centered measures for care satisfaction and cost-effectiveness.
NQF: How has membership in NQF been beneficial to achieving your quality goals?
DL: The Cleveland Clinic has been a member of NQF since 2000. I have attended NQF meetings since 2008 as a delegate representing AAAAI, which joined NQF in 2011. It’s been beneficial for both organizations to have the opportunity to learn from and collaborate with healthcare experts from around the country. I appreciate the opportunity to participate in NQF activities, such as being a member of the Pulmonary and Critical Care Steering Committee, which addressed critical appraisal and approval of quality measures for asthma, COPD, pneumonia, and critical care.