This article appeared a few days ago.
NQF maps out measures for interoperability
The National Quality Forum is set to finalize a framework that can measure health data interoperability and identify gaps in progress.
June 08, 2017 04:02 PM
The National Quality Forum moved closer to finalizing a framework for measuring interoperability. NQF said the framework will help identify in the nation’s progress to enable widespread health data exchange.
The agency’s initiative comes as hospitals and electronic health records vendors are struggling with interoperability and the Office of the National Coordinator for Health IT is working to advance standards that enable information sharing.
“Interoperability is more than EHR to EHR, and all sources of data should be taken into consideration,” NQF said. “All critical data elements should be included in the analysis of measures as interoperability increases access to information.”
To that end, NQF based its work on ONC’s shared nationwide interoperability roadmap to measure information exchange happening in four domains: disparate systems, data to facilitate information sharing, interoperability to enable decision making and, broadly, the impact interoperability can have on healthcare outcomes.
NQF was charged by the Department of Health and Human Services to identify a set of measures around interoperability that would help gauge performance. The goal is to help the healthcare industry improve care management, preventative care and population health management.
More here:
I decided to follow this up and what I found was this.
Interoperability Project 2016-2017
NQF will conduct a multistakeholder review of the current issues and barriers to interoperability and identify a set of proposed measure concepts around interoperability. A conceptual framework will be created to analyze, prioritize, and make recommendations for those concepts to be developed into performance measures.
- REGISTER - (Members Only) 20-Minute Tuesday, Jun 20
- COMMENT - through Jun 30, 6:00pm
- ACCESS REPORT - Final Environmental Scan
- ACCESS REPORT - Key Informant Interview Summary Report
The Opportunity
Interoperability is defined as the extent to which systems and devices can exchange data, and interpret that shared data. One of the goals in using health information technology is to provide comprehensive information on patients at the point of care, as well as integrating information across different sources and sites, so that the provider can evaluate the most appropriate options for patients based on the effectiveness of treatments, including factors such as quality, risk, benefit and costs. Currently the promulgation of common data messaging standards and clinical vocabularies have increased interoperability, but they are not as effective as they could be for the seamless exchange and use of data to derive the maximum benefits of health IT. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.
Over the last few years, there has been an increased awareness by both private and public sectors of the ability to improve the quality and safety of healthcare with interoperable health information technology (HIT) systems. These technologies include electronic health records, personal health records, health information exchanges, and medical devices. As healthcare systems are increasing in their adoption of health IT, a growing amount of data are being gathered. In order for the healthcare industry to move towards better care management for patients, preventative care and population health management, there is need for usable clinical information to flow freely across networks and between hospitals and physicians. For this reason, healthcare organizations need interoperability, an efficient and secure means for hospital computer-based systems and applications to communicate and exchange patient data. However, true interoperability is a significant challenge to healthcare organizations for a number of reasons: lack of a common, standard framework that reconciles the differences in data as well as the varying data types; difficulties in product and system compatibility with existing infrastructures within hospitals; and consistent and persistent struggles internally to disclose the appropriate data within a hospital and with partners in their community. The result is health data that cannot be effectively used across the facility or system levels and that disrupts continuity of care at the patient level.
Objectives
National Quality Forum (NQF) will conduct a multistakeholder review of the current issues and barriers to interoperability and identify a set of proposed measure concepts around interoperability. A conceptual framework will be created to analyze, prioritize, and make recommendations for those concepts to be developed into performance measures.
NQF Process
Over a 12-month period of performance, NQF will complete an environmental scan and key informant interviews; and convene an expert, multistakeholder panel to provide input and help guide the creation of a framework to organize the information in a logical and efficient manner. Throughout this project, NQF will solicit input from NQF’s multistakeholder audience, including NQF membership and public stakeholders at key points throughout the project. NQF will produce a final report, which will include core principles and guidance on how to fill current gaps in measurement of interoperability as well as recommendations for future opportunities for work in the interoperability field.
Here is the link:
The final report draft, which is out for comment until the end of the month, is found here:
To me the executive summary says pretty much is all.
Executive Summary
The definition of interoperability with respect to health IT means health information technology that (1) enables secure exchange and use of electronic health information without special effort by the user; (2) allows for complete access, exchange, and use of all electronically accessible health information for authorized use; and (3) does not constitute information blocking.1 For two systems to be interoperable, they must be able to exchange data in an agreed-upon format according to a standard and subsequently present that data in a way that a user can understand and use.
In concordance with that definition, ONC developed the Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap as well as national standards as part of its certified electronic health record (EHR) technology, which provided nationwide standards for interoperability, both in the exchange of information and in its use. This provided a foundation on which disparate systems could use the appropriate formats and mechanisms to exchange data to assist providers, patients, and other stakeholders. However, true interoperability is a significant challenge to healthcare organizations for various reasons, including the lack of a common, standard framework that reconciles the differences in data as well as the varying data types. Additionally, healthcare organizations maintain incompatible products and systems, which are unable to disclose the appropriate data within the organization and with partners in its community.
As the nation moves towards increased interoperability, a measurement framework would be useful to assess its impact. At the request of the Department of Health and Human Services (HHS), the National Quality Forum (NQF) has taken on a project to develop a measurement framework and measure concepts, which can serve as a foundation for addressing the current gaps in the measurement of interoperability. As a first step towards achieving these goals, NQF conducted an environmental scan and key informant interviews and published the results in the interoperability Environmental Scan Report and the interoperability Key Informant Interview Summary Report. Additionally, NQF convened an expert, multistakeholder Interoperability Committee to provide input and guide the creation of a framework. Throughout this project, NQF solicited input from a multistakeholder audience, including NQF membership and public stakeholders.
The Committee developed the following set of guiding principles that define the key criteria when considering the measure concepts to guide their development into performance measures.
· Interoperability is more than EHR to EHR, and all sources of data should be taken into consideration.
· Various stakeholders with diverse needs are involved in the exchange and use of data, and the use of this framework and measure concepts will differ based on stakeholder perspectives
· The term “electronically exchanged information” should be used instead of “outside data” to completely fulfill the definition of interoperability.
· Interoperability needs will differ depending on the care setting.
· All critical data elements should be included in the analysis of measures as interoperability increases access to information.
The measurement framework contains essential categories (domains) and subcategories (subdomains) needed to ensure comprehensive performance measurement of interoperability. The Committee determined the following domains and subdomains that most accurately measure interoperability and its impact on health outcomes:
Domain
|
Subdomain
|
Exchange of Electronic Health Information
|
· Availability of Electronic Health Information
· Quality of Data Content
· Method of Exchange
|
Usability of Exchanged Electronic Health Information
|
· Relevance
· Comprehensibility
|
Application of Exchanged Electronic Health Information
|
· Human Use
· Computable
|
Impact of Interoperability
|
· Patient Safety
· Cost Savings
· Productivity
· Care Coordination
· Improved Healthcare Processes and Health Outcomes
· Patient/Caregiver Engagement
· Patient/Caregiver Experience
|
Using these domains and subdomains, NQF worked with the Interoperability Committee to examine and develop measure concepts based on information gathered through the literature, the key informant interviews, and the individual knowledge of each of the Committee members. Additionally, NQF examined a large group of quality measures from topics gathered through the literature to identify those that are “interoperability-sensitive” measures, which are quality-of-care metrics designed for reporting from an EHR that are potentially influenced by increased interoperability between EHRs. This framework contains two distinct sections that identify both the measure concepts and measures.
Appendix A includes identified measure concepts aligned with the appropriate domains and subdomains within the report along with a timeline. The estimated timeframe states whether (1) the concepts are useful in the short-term (0-3 years); (2) the concepts will be useful in the mid-term (3-5 years); or (3) the concepts are potentially implementable in the long-term (5+ years). Appendix B shows existing measures as illustrative examples of the measure concepts created by the Committee.”
This seems to define the scope of interoperability and makes it clear it is more like a year’s work – not 5 weeks.
The ADHA might save a lot of time if they read really carefully. Looks pretty good to me.
This from NEHTA in 2012 might also have a few ideas. See here:
I wonder why no references to all this work. Was it that useless?
David.
