The American Health Information Community quality work group met
Wednesday to basically discuss what a world would look like if
healthcare quality-improvement advocates could get all the data they
need, how they would receive it and what would they do with it.
George Isham, chief health officer with Minnesota-based HealthPartners health plan, described the efforts of the
AQA Alliance -- formerly the Ambulatory Care Quality Alliance -- to
develop a National Health Data Stewardship Entity that would set
uniform operating rules and standards for sharing and aggregating
public- and private-sector quality and efficiency measures. Isham
noted the "plethora" of quality organizations operating in
healthcare, and said it would be nice if an existing organization
could serve in this capacity so yet another group wouldn't have to be
created. He added that developing a business model for such an entity
has been a challenge.
Marc Overhage, president and chief executive officer of the Indiana
Health Information Exchange and director for medical informatics at
the Regenstrief Institute in Indianapolis, told the group how his
organization's business model includes charging payers about 30 cents
a month per member for the exchange of health information on some
900,000 insured Indiana residents.
Overhage explained that the focus is on improving outcomes by
providing incentives for improvement and high achievement. Payers are
betting that if they can drive up quality, it can reduce hospitalizations and other high-ticket healthcare service utilization,
he said. The model also calls for "raising all boats," Overhage said,
because most top-performing doctors cannot accommodate more patients.
Overhage added, however, that data collection is expensive so "every
bit of data needs to be used in every way imaginable," but it was
also absolutely necessary that every source of data knows how their
information is being used.
Lynnette Nilan, with the Veterans Affairs Department's Office of
Quality and Performance, told the group how "the VA has the ultimate
electronic medical record at this time," and how it's used to provide
physicians with a patient's last 10 blood-pressure readings, last 15
blood-sugar measures and last radiological image, and how this
information can be obtained in about 10 seconds.
Physicians also get useful feedback and receive quarterly and monthly
performance reports thanks to the aggregation of pharmacy,
laboratory, radiology and surgical data, Nilan said.