One of the criteria for the meaningful use of electronic health record (EHR) technology is the ability to report health quality measures to the Centers for Medicare & Medicaid Services. To that end, the National Quality Forum (NQF) has introduced several health IT initiatives to develop the infrastructure to support this reporting requirement.
The NQF participated in the interoperability showcase at the HIMSS10 annual conference, demonstrating the data collection and reporting of two electronic measures. Dr. Floyd Eisenberg, senior vice president of health IT at the NQF, took some time out from the conference to talk with SearchHealthIT.com about what the organization is doing to ensure that health quality measures can be recorded and submitted electronically. In this video, Eisenberg discusses how the NQF is looking "more for outcomes rather than specific processes," and is retooling a number of measures.
Watch the video to hear more of Eisenberg’s thoughts on measuring health quality using EHR technology, and why a phased approach to implementation is helping the industry move in the right direction.
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Read the full transcript from this video below:
NQF leader on using EHR technology to report health quality measures
Brian Eastwood: Hi, this is Brian Eastwood, Site Editor for SearchHealthIT.com.
I am joined today at HIMSS 10 by Dr. Floyd Eisenberg, the Senior Vice
President for Health Information Technology at the National Quality
Forum. Thank you for joining us, Dr. Eisenberg.
Floyd Eisenberg: Thank You.
Brian Eastwood: First of all, I was just wondering if you can give us your
general impression of the show so far.
Floyd Eisenberg: I think it is a tremendous show, tremendous response and
attendance, especially considering how companies are cutting back on
travel. It really shows how much the Meaningful Use and the
ARRA Response is important to see how many companies are
here, how many people are here to look at what they deliver. I think
it is also nice seeing that it is providing a healthy venue for all of
the attendees. Because we have to walk so much to get to place to
place, it is keeping us all in good health.
Brian Eastwood: In addition to overall health, one of the big topics in health
IT these days is flexibility and standards with the criteria that
providers need to handle for Stage 1. Is the National Quality Forum
thinking about that as it is moves forward with its specifications
for electronic measures, and do you believe providers can handle all
those Stage 1 requirements?
Floyd Eisenberg: That was a few questions. I will try to get them all, but
remind me if I miss one. Where we are moving measurement to, is to
look more for outcomes rather than specific processes which create a
lot of work to find the details that processes have occurred; it is
more important to look at the outcomes. With that said, processes are
still important to measure, to review, to understand that appropriate
care has been given and to be able to provide reminders in closer to
real time for clinical decision support to improve the care during
To do that, we have been approaching measurement from an electronic
standpoint, looking for what data are available and could be available
in electronic records. We are moving ahead and actually in the process
of retooling a large number of measures that also happen to be in the
Notice for Proposed Rulemaking from CMS. That process is addressing
the kinds of data that are needed in order to measure. I clearly
understand, we as an organization clearly understand, the trajectory to
get there does not happen overnight; it takes time for some of this
implementation. When you say Level 1 implementations, the thought is
that the initial set of measures will provide value by helping the industry
know what direction to go, and how data can be formatted so that
in the next year and the year after, the data will be available,
thinking more of the ability to report in the beginning.
In a sense, if we were looking at a sub-payment program, pay for
reporting at the beginning to show that there is a direction to get
there and pay for the actual performance later as the data becomes
available. I think this also raises an opportunity for more than just an
EHR to have to collect all the data. What never comes into the
equation is the expensive cost for an individual clinician, physician,
nurse or otherwise to actually get the data into the system. In order
to make sure the data are there, there are middleware programs that
currently are developing, or in existence, that can help extract from
textual data and from multiple other sources to make sure the data are
available to do the representation of theinformation for measurement, for decision support. I think all of this
is driving the industry in the right direction, understanding there
has to be an incremental approach.
Brian Eastwood: Yes, it is definitely going to be a marathon, and not a sprint.
Floyd Eisenberg: It is. I hear very clearly from vendors, implementers,
providers, physicians, and hospitals about the challenges of, 'Where
do I find this data?' There was a lot of work done in an organization,
Health Information Technology Standards Panel, HITSP, in the last
year, and the Quality Tiger Team retooling 16 impatient measures. It's clear that there are certain elements, that even with the most robust
data entry are going to be hard to capture. What this is doing is help
us identify - not us alone, the industry - identify alternate means to
get what is necessary, alternate means to look at handling exceptions
and exclusions for measures. Clearly no one wants to be measured and
held accountable for things outside their control. Within some
limits of identifying a very small number of patients that might be
excluded, how much extra work is that worth? Are there other ways to
deal with that? All of that is on the table for exploration.
Brian Eastwood: All right. Thank you very much for your time, Dr. Eisenberg, I know
you are having a very busy show.
Floyd Eisenberg: Yes.
Brian Eastwood: This is Brian Eastwood from SearchHealthIT.com. Thank you for
Floyd Eisenberg: Thank you very much.