National Health IT Coordinator David Blumenthal, MD, emphasized Thursday that quality measures are at the heart of his office's strategy for using IT to transform the U.S. healthcare system.
"The key to meaningful use is to know how to measure for performance and to be able to give feedback to providers," he said at a conference sponsored by the National Quality Forum, which promotes and develops quality measures.
The aim is to take existing quality measures and convert them into metrics that can be incorporated into electronic health records in a standard form so they can be compared across practices and geography, he said.
"We expect that to be an ever more important requirement to improve healthcare," Blumenthal said, adding that the National Quality Forum is retooling some existing measures for use in electronic health records.
Under the HITECH provisions of the stimulus law, physicians and hospitals that are meaningful users of electronic health records will be eligible for Medicare and Medicaid incentive payments starting in 2011.
The requirements for meaningful use in 2011 are tasks that many providers already perform, but those for 2013 and 2015 will increasingly support improved patient outcomes, said Paul Tang, chief medical director of the Palo Alto Medical Foundation.
Tang is also a vice chairman of the Health IT Policy Committee, a public-private panel that advises the national health IT coordinator.
Providers will submit quality measures to the Centers for Medicare and Medicaid Services, Tang said. These include widely used metrics, such as the percent of patients with hypertension who have their blood pressure under control, or the percent of patients whose body mass index is recorded to track obesity.
"Just the act of measuring will continuously cause us to improve," Tang said.
Blumenthal emphasized that the meaningful use of electronic health records is not just about introducing technology to collect and share information. It's also about physicians and hospitals changing how they operate and the sequence of their work. "We are involved in a vast social project of change management," he noted.
Providing better information is the foundation for change, he said. Beyond that, physicians and hospitals will need help and training to understand what improvements to make.
"I know this from my own experience as a physician," he said. "You can show me that my results are not up to those of my colleagues. That didn't mean I knew how to improve them."
He cited activities, such as workflow redesign, workforce education and rearranging offices and nurses' stations so that the right information is more accessible.
ONC will help providers adopt these techniques in their own practices through its regional extension center program, which will assist providers in deploying and operating electronic health records.
