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HIT Policy Committee
Quality Measures Workgroup
David LanskyPacific Business Group on Health
November 19, 2010
• David Blumenthal, Chair, MD National Coordinator for Health IT
• David Lansky, Pacific Business Group on Health
• Peter Basch, MedStar • Christine Bechtel, National Partnership
for Women & Families • Tripp Bradd, Skyline Family Practice, VA • Russ Branzell, Poudre Valley Critical
Access Hospital, CO • Helen Burstin, National Quality Forum • Neil Calman, Institute for Family Health • Carol Diamond, Markle Foundation • Timothy Ferris, Partners Healthcare • Patrick Gordon, Colorado Regional
Health Information Organization
• David Kendrick, Greater Tulsa Health Access Network, OK
• Charles Kennedy, WellPoint, Inc. • Karen Kmetik, American Medical
Association • Robert Kocher, McKinsey & Co • J. Marc Overhage, Regenstrief Institute • Laura Petersen, Baylor University • Jacob Reider, AllScripts • Cary Sennett, MedAssurant • Jesse Singer, NYC Department of Health • Paul Tang, Palo Alto Medical Foundation • Kalahn Taylor-Clark, Brookings Institute • James Walker, Geisinger • Paul Wallace, Kaiser Permanente
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Quality Measures Workgroup Members
Measure Concept Sub-Domain
Measures of patient activation, including skills, knowledge, and self-efficacy
Self-Management/Activation
Measures of patient self-management
Measures of shared decision making or decision quality that address a combination of patient knowledge and incorporation of patient preferences
Honoring Patient Preferences and Shared Decision Making
Measures of the patient preferences/ experience of care
Measure of patient health outcomes, including health risk status, functional health status, and global measures of patient health
Patient Health Outcomes
Measure of patient access to community resources for improved/ sustainable care coordination
Community Resources Coordination/ Connection
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Patient and Family Engagement
Italics indicates a measure concept that has overlap with other Federal goals
4
Clinical Appropriateness
Measure Concept Sub-Domain
Measure of all cause readmissions and length of stay Appropriate/Efficient Use of Facilities
Assessment of ambulatory care sensitive preventable admissions
Assessment of the appropriate use of diagnostic imaging procedures, with measures for redundancy, cumulative exposure, and appropriateness
Appropriate/Efficient Use of Diagnostic Test
Measure of the development of co-morbidities as a result of uncontrolled chronic disease (sequelae of uncontrolled diabetes)
Appropriate/Efficient Treatment of Chronic Disease across Multiple Sites of Care
Measure of reconciliation of care plan for chronic disease patients across care settings and multiple specialists (process measure)
Assessment of appropriate medication treatments, including overuse and/or underuse
Appropriate/Efficient Use of Medications
Measure of medication use linked to adherence outcomes
Assessment of measure usage rates for generic vs. brand name medications
Measure of appropriate use of cardioprotective medications—aspirin, angiotensin-converting enzyme inhibitors, and statins—in individuals at high risk of experiencing heart attacks and strokes.
Italics indicates a measure concept that has overlap with other Federal goals
5
Care Coordination
Measure Concept Sub-Domain
Measure of the adherence to a comprehensive care plan in the EHR with an up to date problem list and care plan that reflects goals of care
Effective Care Planning
Measure of an Advance Care Plan as a product of shared decision making
Measure of the success of a self management plan for patients with conditions where a self management plan might reasonably be considered to benefit them
Measure of reconciliation of all medications when receiving a patient from different provider
Care Transitions
Measure of patient and family experience of care coordination across a care transition (e.g. questions within HCAHP surveys)
Composite measure of receipt by both the care team members and the patient/caregiver of a comprehensive clinical summary after any care transition
Measure of an assessment of timeliness of provider and appropriate response to clinical information, including lab and diagnostic results
Appropriate and Timely Follow-Up
Italics indicates a measure concept that has overlap with other Federal goals
6
Patient Safety
Measure Concept Sub-Domain
Measure of adverse drug events through the FDA Adverse Event Reporting System (AERS) database
Medication Safety
Measure monitoring drug safety for patients who are on chronic medical therapy (e.g.: Warfarin)
Measure of patient reported adverse events
Measures of process and outcome improvement of hospital associated infections
Hospital Associated Events
Measures of venous thromboembolism (VTE) prophylaxis and VTE rates
Measures of falls events and screening
Italics indicates a measure concept that has overlap with other Federal goals
7
Population and Public Health
Measure Concept Sub-Domain
Measure of use/availability of services that promote healthy lifestyles (smoking cessation, body mass index management, patient health literacy): A) Smoking cessation focused specifically on quit rate for patients within a reporting period. B) Body Mass Index focused specifically on tracking longitudinal change to determine patient outcome.
Healthy Lifestyle Behaviors
Measure of screening for alcohol use using a validated tool
Measure of mental health screening using a validated instrument Effective Preventative Services
Measure of blood pressure focused specifically on tracking longitudinal change to determine patient outcome
Measure of glucose monitoring focused specifically on tracking longitudinal change to determine patient outcome
Health Equity focuses on measures with no discrepancy when comparing health outcomes among those within priority populations to those not within the priority populations
Health Equity
Italics indicates a measure concept that has overlap with other Federal goals
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Other
Measure Concept
Assess preventable ED visits
Assessment of adherence to clinical practice standards (appropriate cardiac/cancer treatments)
Assessment of combined quality and cost measures at each level and site of care reflecting potential defects in care
Measure of medication error near misses
Measure of patient identification errors and near misses
Measure of common EHR related errors (mechanism to report EHR related errors and delays in care to improve EHRs)
Italics indicates a measure concept that has overlap with other Federal goals
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