Promoting the use of health information technology and reducing the data-collection burden required for quality-reporting programs are two efforts that should not be occurring in independent silos, and a merging of these two efforts will pay off in the future, according to participants in the Jan. 9 meeting of the American Health Information Community's quality work group.
AHIC is an HHS advisory panel, and the quality work group is developing a letter to HHS Secretary Mike Leavitt that -- for now, at least -- includes a listing of "barriers and enablers" to its goals and a set of recommendations with a list of the principles they are based on. The draft of the letter discussed was described as a very preliminary first step, and is dated March 7, although that date was described as a flexible target and not an absolute deadline.
Among the principles being discussed is one that states how the group "will not prescribe specific solutions in areas where market experimentation is currently helping to inform market consensus," such as data-aggregation approaches, public-reporting formats and payment reforms. Another is that, since electronic health records "will not be the only form of data capture in the foreseeable future," several solutions are necessary to decrease the burden of reporting requirements.
To this end, Margaret VanAmringe, Joint Commission vice president for public policy and government relations, noted that a core set of data elements which are required for a majority of performance measures should be identified.
Josie Williams, a physician, who is the director of the Texas A&M System Health Science Center's Rural and Community Health Institute in College Station, agreed and said that the more specific the panel can be in the beginning with defining a "data dictionary," the easier the process will be in the long run.
Some of the barriers and enablers identified in the draft included developing a business case for automating quality measurement in tandem with developing incentives for EHR use and data sharing; addressing security and privacy concerns; and changing business processes and workflow to ensure the uniform capture of data.
VanAmringe said that, since patient identification is "such a red flag" in data collection, she said the letter should make clear that the desire to use healthcare data is being balanced with concerns about privacy and security.
The work group's co-chairwoman, Carolyn Clancy, the director of the Agency for Healthcare Research and Quality, agreed.Clancy also noted that the developers of performance measures generally are not thinking about data collection during the development process, and there is not an "off-the-shelf solution" to the painful lessons healthcare organizations experience as they simultaneously fulfill data-collection requirements and begin implementing IT systems.
Among the recommendations under discussion in the preliminary draft were the automation of data capture and reporting to support a core set of quality measures put forth by the AQA (formerly the Ambulatory Care Quality Alliance) and the Hospital Quality Alliance, as well as creating an "expert panel" to identify the workflow changes that data-capture efforts would require.
Kelly Cronin, director of the Office of the National Coordinator for Health Information Technology's Office of Programs and Coordination, noted that while expert input was definitely needed, "There's a real risk of volunteer burnout." She suggested that experts who are called upon to help merge IT promotion and quality-reporting initiatives should be compensated for their efforts.
Read the preliminary draft.What do you think? Write us with your comments at [email protected]. Please include your name, title and hometown.