NQF Proposes Approaches to Assess, Improve Telehealth Quality and Interoperability 

Washington, DC—The National Quality Forum (NQF) has issued two new reports that provide national guidance to advance health information technology to make healthcare more effective and safer for all Americans. In one report, NQF identifies critical areas where measurement can effectively assess the quality and impact of telehealth services. In another report, NQF assesses the current state of interoperability and its impact on quality processes and outcomes.

“Telehealth is a vital resource, especially for people in rural areas seeking help from specialists, such as mental health providers,” said Marcia Ward, PhD, director of the Rural Telehealth Research Center at the University of Iowa, and co-chair of NQF’s Telehealth Committee. “Telehealth is healthcare. It is critically important that we measure the quality of telehealth and identify areas for improvement just as we do for in-person care.”

Telehealth services, which unite technology with healthcare, health information, and health education, have grown substantially over the past 15 years and are expected to increase due to new reimbursement strategies for Medicare providers who offer telehealth services as part of the Medicare Access and CHIP Reauthorization Act (MACRA).

NQF recommends measuring the quality of telehealth in four broad categories: patients’ access to care, financial impact to patients and their care team, patient and clinician experience, and effectiveness of clinical and operational systems. Within these categories, NQF identified six key areas as having the highest priority for measurement in telehealth, including: travel, timeliness of care, actionable information, added value of telehealth to provide evidence-based practices, patient empowerment, and care coordination.

NQF’s Telehealth Committee identified 16 NQF-endorsed measures that can be used initially to measure telehealth quality in the structure outlined above. These measures span a variety of conditions, ranging from mental and behavioral health to care coordination.

“For many patients, telehealth can mean the difference between seeing their doctor or receiving no care at all,” said Judd Hollander, MD, associate dean for strategic health initiatives at Thomas Jefferson University, and co-chair of NQF’s Telehealth Committee. “NQF’s framework for measuring telehealth quality will be key to helping ensure quality care, no matter where people access it.”

In a separate report, NQF proposes measuring interoperability—the electronic sharing of health information and how that information is being used—in four broad categories: the exchange of electronic health information, its usability, its application, and its impact—on patient safety, costs, productivity, care coordination, processes and outcomes, and patients’ and caregivers’ experience and engagement.

NQF’s Interoperability Committee identified 53 ideas for measures that would be useful in the short term (0-3 years), in the mid-term (3-5 years) and in the long-term (5+ years). It also identified 36 existing measures that serve as representative examples of these measure ideas and how they could be affected by interoperability.

“NQF’s interoperability framework lays the groundwork to accomplish national priorities for interoperability, access, and use of health data outlined in the 21st Century Cures Act,” said Mark Savage, director, health policy at the University of California San Francisco’s Center for Digital Health Innovation. “This framework gives important guidance on key concepts where measures are needed to identify the extent or lack of interoperability so that we can make it a reality across the continuum of care. This guidance will help ensure that both providers and patients have the data they need to assess the relative quality and value of care and determine next steps.”

The U.S. Department of Health and Human Services funded NQF’s projects to improve telehealth quality, assess progress toward interoperability, and assess the impact of interoperability on quality processes and outcomes. NQF’s interoperability project serves as a foundation for addressing the current gaps in the measurement of interoperability.

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The National Quality Forum leads national collaboration to improve health and healthcare quality through measurement. Learn more at www.qualityforum.org.