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

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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

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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

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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

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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