Blended Data for Quality Measures
The National Quality Forum is in the process of establishing consensus standards for the use of clinically enriched administrative data for reporting performance measures in ambulatory care. In January an NQF work group began identifying and endorsing a set of measures suitable for both public accountability and quality improvement.
Given the difficulty of reporting performance measures from paper records, healthcare has been making do by using administrative data, the only data widely available in electronic form. The trade-off is the quality of the quality measures: administrative data produce a narrow and less reliable look at the care delivered.
(In the worst case, as a Boston Globe story on Google Health related earlier this month, poorly managed use of claims data can result in outright misrepresentation of care delivered. The Journal wrote about this danger in personal health records back in April 2007.)
An emerging, intermediate solution is to mix administrative data with the clinical data most likely to be available electronically now—laboratory and pharmacy information. The results are promising. Research sponsored by the Agency for Healthcare Research and Quality has shown that the blend improves the accuracy of the measures. (Also see “Improving the Quality of Quality Measures” from the Journal April 2009 print issue.)
NQF steering committee members are evaluating more than 100 potential measures on their scientific acceptability, usability, and feasibility, says Margaret Skurka, MS, RHIA, CCS, FAHIMA. Skurka, a steering committee member, is professor and director of the Department of Health Information Management at Indiana University Northwest in Gary. The group is focusing on “high-impact” measures that can improve routine care, she reports.
Skurka believes that HIM involvement has broadened the committee’s scope. For instance, physician members evaluate a measure on its ability to illustrate quality of care, and HIM expertise has helped evaluate “how easily that data piece is retrievable from coded data,” she says.
Once the group works its way through a review of each potential measure, it will submit the resulting list for public comment. NQF expects to announce the review this summer.