Two interesting reports were released in the last week or two.
Posted: January 6, 2011 - 12:00 pm ET
The National Quality Forum released two reports Thursday about health information technology and performance improvement. The first report provides a model for measuring use of health IT, according to a news release from the Washington-based organization, while the second focuses on potential quality gains form clinical decision support systems.
The reports stem from work done by NQF’s Health Information Technology Utilization Expert Panel as well as its Clinical Decision Support Expert Panel.
Here is the project description from the first:
Health Information Technology Utilization Expert Panel
Expert Panel Report:
Health information technology (HIT) has the potential to improve the quality and efficiency of our healthcare system. As clinicians and health care organizations increasingly adopt certified electronic health records (EHRs), a critical next step beyond EHR acquisition is to promote effective health IT utilization. Measuring effective utilization will require identifying system capabilities needed to track and monitor when and how health IT is used.
While quality measures evaluate clinical conditions, structural measures evaluate infrastructure. In August 2008, NQF endorsed nine HIT structural consensus standards to assess and encourage HIT adoption by clinicians. The next step in the process is to determine effective usage automatically from the logs in the EHR system, such as which components have been used, by whom, and how often (e.g. frequency of electronic laboratory ordering or electronic prescriptions). Current measures require the clinician to manually enter a quality code every time an electronic prescription is ordered. It seems logical that the EHR, and health IT in general, should keep track of such activity and automatically measure that utilization. Therefore, this expert panel will develop a model that can provide specific data elements to inform future performance measures and practices, including those to identify unintended consequences of health IT usage.
About the Project
In January 2010, the National Quality Forum (NQF) convened the Health Information Technology Utilization Expert Panel to examine, define, and organize the information needed to measure effective health IT use.
The Expert Panel’s output, the Health IT Utilization Assessment Framework is designed to help define a method for expressing data that can be captured by health IT systems to understand and measure their usage.
Here is the abstract:
Health information technology (health IT) offers great promise to improve healthcare quality, safety, and affordability, and the health of the population. Passage of the recent Health Information Technology for Economic and Clinical Health Act (HITECH) in the American Recovery and Reinvestment Act (ARRA) is expected to significantly drive increased adoption of health IT systems. This report examines, defines, and organizes the data needed to measure effective health IT use to better understand how health IT tools can improve healthcare delivery. The Health IT Utilization Assessment Framework is designed to define a method for expressing data that can be captured by health IT systems to understand and measure their effectiveness. Health IT use assessment can provide valuable information for most healthcare stakeholders, including the quality improvement community, the health IT vendor community, providers, payers, purchasers, and policymakers.
and the second:
Clinical Decision Support Expert Panel
Expert Panel Report:
To improve healthcare quality, safety, and effectiveness, relevant clinical knowledge represented within quality measures and guidelines of care must be evident at the point of care and implemented in a manner that promotes optimal care. Properly positioned, clinical decision support (CDS) tools can play an important role in matching patient information with relevant clinical knowledge to help users incorporate that knowledge into decisionmaking.
Decision support can be broadly defined as any tool or technique that enhances decisionmaking by clinicians, patients, and/or their surrogates in the delivery or management of health and healthcare. CDS is an essential capability of health IT systems; however, a common classification of information that connects quality improvement information and CDS is needed.
About the Project
In November 2009, the National Quality Forum (NQF) convened the CDS Expert Panel to develop the NQF CDS Taxonomy, a classification of the information that connects quality measurement and CDS in clinical information systems.
Here is the abstract:
Increasing deployment, adoption, and meaningful use of electronic health records (EHRs) and health IT systems in the United States offers great potential to im¬prove the healthcare system. An important means to advance this goal is to measure performance, ensuring that relevant clinical knowledge is available at the point of care and implemented in a manner that promotes optimal care delivery. Properly positioned, clinical decision support (CDS) tools can play an important role. This report describes the development of the NQF CDS Taxonomy, the relationship between quality measurement and CDS, and the mapping of the Taxonomy to the QDS Model—an information model that lays the foundation for automatic, patient-centric, longitudinal quality measurement. The CDS Taxonomy should assist health IT system developers, system implementers, and the quality improvement community to develop tools, content, and procedures that are compatible and enable comprehensive use of CDS, thereby improving delivery of appropriate, evidenced-based care.
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Both these reports contain very useful information and especially the first will make it clear that the US believes what you place in the hands of clinicians and then measure is much more important that what is in the hands of patients - until at least the frailties of the clinicians in information management and sharing are much more fully addressed.
As far as the second report is concerned it is discussing a future state in Clinical Decision Support (CDS) we are a little way from just yet! Nevertheless we need to be working to get there!