DRAFT
Alliance for Pediatric QualityQuality Reporting HIT Standards Project
July 2007
DRAFT 2www.kidsquality.org
1.Goal2.Participants3.Rationale 4.Project Overview5.How to Participate
DRAFT 3www.kidsquality.org
Quality Reporting Document Architecture
Develop a standard for healthcare information systems to communicate quality
measurement data across disparate systems in a standardized fashion.
QRDA: Project Goal
DRAFT 4www.kidsquality.org
Founders
Project Management
HL7 Sponsor
Primary BenefactorFor Phase One
PeDS SIG
Participants: A Private Collaborative
PeDS SIG
DRAFT 5www.kidsquality.org
Using Data for Quality Performance Measurement
*Problem Time-consuming and problematic
operations for data acquisition from electronic systems
Multiple and disparate systems within health care organizations complicate data mining and coordination of efforts
Resource-intensive data mapping efforts to link systems and performance measurement data requirements
Conflicts or differences between administrative data sets
Physicians and providers struggle to meet increasing demands for performance data
*Source: Agency for Healthcare Research & Quality
Opportunity Support efficient collection,
aggregation and reporting of quality measurement information• Among providers within a
healthcare system• Among providers from different
healthcare systems• Among providers and requestors
of quality data (e.g. QIOs, payers, accrediting orgs, etc.)
• More…
Support adoption of quality measurement• Among developers of health
information technology systems• Among providers and payers
DRAFT 6www.kidsquality.org
Example: Traditional Quality Measure Reporting
MedicalRecord
(Paper, EMR)
Manual AbstractionAdministrative DataAd Hoc FormsAd Hoc Databases
IT Assistance,Manual Data Entry
Provider
scrubbing
periodic reportingdocumentation
Requestors of Quality Data
(e.g. quality improvementorganization)
Requestors of Quality Data
(e.g. payer)
Requestors of Quality Data
(e.g. accrediting org)
IT Assistance,Manual Data Entry
IT Assistance,Manual Data Entry
Provider sends one set of measure information to multiple requestors of quality data
DRAFT 7www.kidsquality.org
Example: QRDA Simplifies Quality Measure Reporting
MedicalRecord
(Paper, EMR)
Manual AbstractionAdministrative DataAd Hoc FormsAd Hoc Databases
Provider
HL7 v3 message, QRDA
periodic reportingdocumentation
Requestors of Quality Data
(e.g. quality improvementOrganization)
Requestors of Quality Data
(e.g. payer)
Requestors of Quality Data
(e.g. accrediting org)
Provider sends one set of measure information to multiple requestors of quality data
DRAFT 8www.kidsquality.org
Hosp
ital or
Am
bula
tory
In
form
ati
on S
yst
em
ADT
RIS/PACS
LIS
PIS
Requestors of Quality Data
EDIS
QRDA
HL7 v3 Standard Specification
DRAFT 9www.kidsquality.org
Goal: Shared Approach to Document Architecture
Quality ReportingDocument Architecture
Measure NameMeasure SetSubmitting EntityReceiving EntityProcedure CodeDiagnosis CodeLab ResultsCriteriaPatient/Provider dataEtc…
quality measure
Data Elements inCommon Format
Measure NameMeasure SetSubmitting EntityReceiving EntityProcedure CodeDiagnosis CodeLab ResultsCriteriaPatient/Provider dataetc.
quality measur
e
quality measur
e
DRAFT 10www.kidsquality.org
Phase One: Define project opportunity Select standards
development expert for support
Secure endorsement and funding
Recruit volunteers Develop prototype QRDA-
compliant reports Make recommendations
for moving forward Secure endorsement and
funding for Phase Two
QRDA Project Overview
Phase Two: Ballot and publish QRDA
Draft Standard for Trial Use through HL7
Training material and support for vendors adopting the QRDA for pilot measures; Guidelines on prioritized reporting measures
Conduct proof of concept demonstrations
3 months TBD
DRAFT 11www.kidsquality.org
1. Data elements for pilot measures Using NQF-endorsed quality measures; 2 adult outpatient; 2 pediatric inpatient
2. Minimum of two clinical document architecture samples of quality reporting document
3. Training and education for project team and interested stakeholders
4. Description of relationship of this project with other, similar efforts
5. Coordination with related efforts6. Description of options for moving forward7. Definition of benefit from IT perspective8. Webcast on findings
Major Phase One Deliverables
DRAFT 12www.kidsquality.org
Certification Commission for Health Information Technology- For possible vendor certification of the QRDA standard
Collaborative for Performance Measure Integration with EHR Systems- Addressing performance measure functionality and integration with EHRs- Facilitating integration, calculation and reporting of measures within vendor products for reporting - Includes American Medical Association, National Committee on Quality Assurance and Centers for
Medicare & Medicaid Services
Health Information Technology Standards PanelAmerican Health Information Community- Promoting automation of quality data reporting - Developing quality use cases
Health Level Seven- Vehicle for publishing the QRDA standard- Working with Clinical Interoperability Council, Electronic Health Record Technical Committee, Government
SIG, Pediatric Data Standards SIG, Structured Documents Technical Committee, and more
Integrating the Healthcare Enterprise- Driving vendor adoption of standards
Leverage and Harmonize With Others
DRAFT 13www.kidsquality.org
Phase One: Volunteer Opportunities
Volunteer Opportunities Expertise Immediate Commitments
Technical Content Experts (Source Organizations) hospitals and physician offices adult and pediatric
Have understanding of how quality measurement data is collected and sent to receiving organizations
Private phone call in July with consultant to share experiences Review of draft deliverables and conference call Aug. 14, 1-2:30 pm CST to react
Technical Content Experts (Receiver Organizations)
Have understanding of how quality measurement data is captured and reported
Private phone call in July with consultant to share experiences Review of draft deliverables and conference call Aug. 14, 1-2:30 pm CST to react
Clinical Content Experts Have familiarity with clinical content of some or all of the sample quality measures being used in this project
Available to respond to email and/or phone questions about sample quality measures used for this project
HL7 Experts Have an interest in learning the HL7 method for developing future vendor implementation guides for quality measures using QRDA
Involvement in major project activities Participation in training later in the project
Connectors Have an understanding of related activities within other organizations
Help the project team connect dots with other activities
DRAFT 14www.kidsquality.org
Volunteer List – How to Participate
Volunteer Roles Volunteers
Technical Content Experts (Source Organizations)
Feliciano Yu, MD. Children’s Hospital of Alabama Chad Bennett, Iowa Foundation for Medical Care TBD
Technical Content Experts (Receiver Organizations)
Bob Underwood, CHCA TBD
Clinical Content Experts TBD
HL7 Experts Bob Underwood, CHCA TBD
Connectors TBD
Contact [email protected] if you are interested in: serving on the phase one project team in one of the volunteer roles joining an email list to stay up-to-date on major project activities
DRAFT 15www.kidsquality.org
Chad BennettIowa Foundation for Medical CareThe Collaborative for Performance Measure Integration with EHR [email protected]
Crystal KallemAmerican Health Information Management Association (AHIMA)HL7 Structured Documents Technical [email protected]
Joy Kuhl, Project FacilitatorAlliance for Pediatric QualityHL7 Pediatric Data Standards Special Interest [email protected]
Feliciano Yu, MDHL7 Pediatric Data Standards Special Interest GroupThe Children’s Hospital of [email protected]
Primary Project Contacts
DRAFT
Alliance for Pediatric Quality
DRAFT 17www.kidsquality.org
200+ children’s hospitals and 60,000 pediatricians using the same play book to improve care
Alignment of physicians and hospitals is essential to improvement progress
Combined expertise and spheres of influence will accelerate improved quality for children
HospitalHospitalCommunityCommunity
PhysicianPhysicianCommunityCommunity
Four national pediatric organizations aligned to improve the qualityof health care for America’s children.
Alliance for Pediatric Quality
DRAFT 18www.kidsquality.org
Alliance Goals & Strategies
1. Promote meaningful pediatric improvement and measures Promote initiatives using measures for
improvement Spread use of measures for improvement and
public reporting Develop a comprehensive catalogue of
pediatric improvement priorities and measures
2. Ensure health information technology works for children Seek industry-wide adoption of data
standards for pediatrics Promote integration of child health EHR-S
standards into vendor systems Endorse pediatric data standards that make
comparability possible
3. Explore opportunities for collecting and sharing data
Our Strategies Work for consensus – speak with one
voice for improvement in quality for children; advance pediatric improvement initiatives, measures and data/health information technology
Endorse and promote projects that advance pediatric quality and health information technology
Convene stakeholders
Advocate in media and legislature
DRAFT 19www.kidsquality.org
Project Fit With Alliance Mission
Alliance for Pediatric Quality
HL7 PeDSSIGWith other HL7 committees,
organizations and vendors within the HL7 enterprise
• Lead, shape and accelerate recognition and adoption of quality improvement• Promotes improvement priorities • Provides specific data elements for pediatric quality measures• Maps data elements to HL7 RIM• Develops HL7 v3 Implementation Guideline for measure/s using QRDA standard
VendorEMR systems and other systems
• Adopts HL7 implementation plan through system updates• Develops internal logic/algorithms to capture data elements for specific measure/s• Validates and tests accuracy of data output for specific measure
Reporting Facility
Practice/Healthcare Institution
• Purchases vendor that complies with HL7 standards• Receives functionality through vendor system• Participates in reporting to Improvement Organization (s)
Requestors of Quality Data
Or other central quality assurance bodies such as CHCA, NACHRI, etc.
• Accepts QRDA data-submissions for benchmarking
CCHIT • Possible vendor certification of compliance