NQF Report and Meaningful Use

A June 9 NQF report has some good criteria outlining how a limited set of metrics can be defined as a foundation for quality reporting aspects of the ARRA "meaningful use" criteria:

Follow this link to the report - a must read

The high-level framework (page 50) is as follows quoted verbatim:

Criteria for prioritizing measures for retooling

• Is the measure related to a national priority or high impact condition? Does it explicitly impact value/cost?
• Does the measure effectively leverage HIT?
• Does the measure reflect a more credible representation of quality?
• Is the measure sensitive to effective coordination of care or data sharing across sites,providers and patients?
• Does the measure reflect the use of innovative, patient‐centered data sources (bidirectional)?

Health IT sensitive criteria may include the following criteria:

• Does the measure depend on the presence of an EHR and its effective use? In order to efficiently report on the measure and demonstrate good results, theorganization would need to have implemented a capable EHR and the clinicians wouldhave to be using it effectively

• Does the measure reflect the use of innovative, patient‐centered data sources?

• Examples:
• Measure includes assessment of patient home monitoring (e.g., blood glucose monitoring)
• Measure includes patient‐reported health status (e.g., completion of PHQ‐9 depression screening tool by patients)

• Is the measure sensitive to effective coordination of care or data sharing across sites and providers?

• Examples:
• Coordination of care examples: measures include information that would need to beshared across sites (e.g., medication reconciliation), coordination between clinicians(e.g., timely receipt of consult notes).
• Data sharing example: Percent of surgical site infections (SSIs) occurring within 30 daysafter operative procedure if no implant left in place – includes capacity to captureinfection information from ambulatory care to calculate accurate SSI rate.

With more than 500 measures in the NQF portfolio, available measures could be deemed “healthIT sensitive.” The health IT‐sensitive starter set should be comprehensive and applicable across health care settings. These measures will require the inclusion of key clinical data only available in electronic health record systems (e.g., data from problem list and medication lists), and that encourage use of essential components of the EHR.