The nation’s shift toward interoperable electronic health records (EHRs) offers the promise of collecting and reporting innovative performance measures that address critical performance measurement gaps. Use of this technology will eventually enable clinicians and health systems to consistently identify patients with specific conditions or interventions, in a given population or setting, and to provide patient-centered, coordinated, care integrated leading to improved healthcare outcomes.
However, to meet this promise, measure development needs electronic clinical data standards and reusable “building blocks” of clinical terminologies to ensure that measures can be consistently and accurately implemented across disparate health information technology systems. These coded vocabulary groups, known as “value sets,” provide definitions of the data elements necessary to calculate eClinical Quality Measures (eCQMs) under the federal Meaningful Use program as well as other national reporting initiatives.
There are about 70,000 value sets in the National Library of Medicine’s (NLM) Value Set Authority Center (VSAC), which was created in 2012 in conjunction with the Office of the National Coordinator for Health Information Technology and the Centers for Medicare & Medicaid Services. While the NLM curates the value sets to ensure the codes are not incorrect, there also is a need to validate the clinical meaning of codes and assess multiple competing value sets addressing the same intended purpose.
An NQF project launched this year is doing just that. The project will develop and pilot test a value set harmonization process to eliminate unnecessary variance from common value sets in eCQMs. The project also will offer guidance on how harmonized value sets should be integrated into the eCQM evaluation and endorsement process.
The project is guided by a multistakeholder committee with broad expertise in health information technology policy, measure development, clinical information systems, coding, and interoperability, as well as specific technical expert panels comprised of clinical coding experts, measure developers, methodologists, EHR vendors, and specialists in clinical process and structure.
A draft project report is expected in November, and a public comment period will follow.