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New research from the National Quality Forum supports the use of effective IT tools and promotes clinical decision support.
Two reports, “Driving Quality: A Model to Measure Electronic Health IT Use” and “Driving Quality and Performance Measurement: A Foundation for Clinical Decision Support,” also delve into ways to measure health IT use.
"These reports provide a tremendous foundation for future work in clinical decision support and for understanding the impact of health IT tools on care delivery," said Janet Corrigan, the NQF’s president and CEO. "It also lays the groundwork for what kind of standards and certification criteria should be considered and put into practice for health IT use measures."
Identifying and developing health IT use measures and tracking performance on these measures requires an understanding of a system's features and functions and when and how they are used. The “Driving Quality: A Model to Measure Electronic Health IT Use” report, based on the work of NQF's Health Information Technology Utilization Expert Panel, developed the "Health IT Use Assessment Framework."
The framework provides a unique approach to measuring the use of health IT tools and how that use improves care processes, quality and safety. As health IT use measures are developed, the framework will provide clear guidelines for the information needed to construct these measures.
The expert panel's work expands on the Quality Data Set. The QDS is "a model of information" that describes clinical concepts used in quality measurement and clinical care so providers, researchers, measure developers and others monitoring clinical performance and outcomes can consistently communicate necessary information.
The QDS model also describes information in a manner that allows EHR and other health IT vendors to interpret the data and locate the data required.
"This report establishes an essential foundation on which measures of health IT utilization can be developed and used to assess the adoption and effective use of these clinical information systems," said Blackford Middleton, MD, chairman of the Health IT Utilization Expert Panel. "This is critical to determine whether both clinical quality and policy goals are being met for meaningful use under the HITECH Act and helps establish a 'dose-response' curve for health IT when used in practice."
CDS tools are an essential health IT system capability and will play an important role in improving healthcare quality, safety and effectiveness, Middleton added. As such, a common categorization, or "taxonomy," is necessary to enable health IT system developers, system implementers and the quality improvement community to develop tools, content and policies compatible with CDS features and functions.
The NQF convened the Clinical Decision Support Expert Panel to develop the CDS taxonomy. The “Driving Quality and Performance Measurement: A Foundation for Clinical Decision Support” report provides a foundation for the description of an electronic infrastructure, bridging quality measurement and health IT.
"Improving both documentation and performance on priority quality measures is fundamental to achieving and demonstrating the meaningful use of health IT," said Michael Krall, MD, chairman of the CDS Expert Panel that drafted the report. "The NQF CDS Taxonomy makes a major contribution to this by providing a means to better understand and articulate the role of CDS in improving performance and patient outcomes. This will result in enhanced design and implementation of CDS within EHRs and help to substantially increase HIT effectiveness."
"This rich body of work will enable patients and providers to better access and apply evidence-based information in decision making about health, wellness and care delivery and assess the full impact of EHRs and other health IT tools on patient care and quality improvement overall," added Floyd Eisenberg, MD, the NQF's senior vice president for HIT.
