Overview
Supported by CMS, NQF will convene a diverse, multistakeholder Committee to identify best practices to leverage electronic health record (EHR) sourced measures to improve care communication and coordination quality measurement in an all-payer, cross-setting, fully electronic manner.
The Opportunity
Effective, high-quality care communication and coordination is essential to improve health outcomes and reduce avoidable costs of care. Measuring care communication and coordination has been challenging because of the heterogeneity of approaches and interventions, difficulties in measuring specific activities, as well as difficulties in generalizing program success and linking approaches to improved outcomes. One of the opportunities that has not been fully explored is leveraging electronic health records (EHRs) and EHR data to measure care communication and care coordination. Prior initiatives funded by the Centers for Medicare and Medicaid (CMS) and conducted by the National Quality Forum (NQF) has identified EHR systems as important tools for quality measurement as well as tools to deliver high quality care. However, to date, EHR data have primarily supported patient care and billing, and have not been fully realized, particularly in their ability to measure care communication and coordination. Within EHRs, technology tools and specific design features have been effectively deployed to help facilitate care coordination. This allows EHRs to serve as a way to improve care coordination and provide a key data source for quality measurement. In this CMS-supported project, NQF will convene a multistakeholder Committee to identify best practices to leverage EHR sourced measures to improve care communication and coordination quality measurement in an all-payer, cross-setting, fully electronic manner.
About the Project
The Committee will address this issue in two 12-month phases (Base Year and Option Year). In the Base Year, the Committee will work with NQF staff to perform an environmental scan. The environmental scan report will identify a consensus definition of care communication and coordination; establish the relationship between care communication and coordination and improved healthcare outcomes; and outline the challenges of measuring provider performance on care communication and coordination in an all-payer, cross-setting, fully electronic manner. A report detailing the findings of the environmental scan will be released for public comment. In a second Option Year, the Committee may work with NQF staff to provide recommendations for how EHRs could better facilitate care communication and coordination, how EHR sourced measures can be used to improve care communication and coordination, and possible EHR sourced care communication and coordination measure concepts or specific areas of measurement within care communication and coordination. The recommendations identified by the Committee and how they may be applied will be documented in the Final Recommendations Report, which will also be released for public comment at the end of the second Option Year.
Objectives
- Review existing definitions of care communication and coordination and generate consensus definitions for both
- Review and give feedback on improving the environmental scan strategy
- Provide iterative feedback on environmental scan report
- Give guidance to NQF staff in interpreting information gathered from the expert interviews
- Help guide the development of a draft recommendations report that captures best practices leveraging EHR-sourced measures for care communication and care coordination
NQF Process
The overall goal of the 12-month period of performance (i.e., Base Year) will be to generate an environmental scan report that describes current practices in use by a variety of stakeholders – including clinicians, case managers, social workers and community-based organizations, specialty societies, etc. – to leverage EHRs to both measure and improve care communication and care coordination. To complete this work, NQF will develop a consensus definition of care communication and care coordination from the wide variety of existing definitions in the literature. The report will describe a comprehensive list of existing EHR-sourced measures for care communication and coordination, identify where existing CQMs may be modifiable into eCQMs, and identify tools, processes, and approaches that exist within EHRs that may improve care coordination. In particular, the scan will aim to find measures or other tools that are associated with improved health outcomes for patients or seek ways that EHRs can directly measure care communication and coordination outcomes. NQF will focus this work across settings where EHRs are used, including hospitals, clinics, skilled nursing facilities, and others. NQF will also conduct this work with all-payers and all patients in mind, as coordination activities and outcomes can vary across types of insurance and sociodemographic groups A report detailing the findings of the environmental scan will be released for public comment. NQF also will document the recommendations identified by the Committee and how they may be applied in a second report that will also be released for public comment.
Funding
This project is funded under a contract with the Centers for Medicare & Medicaid Services. For information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.
Related NQF Work
Contact Information
For more information, please contact the project team at EHRCareCoordination@qualityforum.org. Thank you for your interest.