Automating Performance Measurement Using Electronic Health Records

Health quality measure format ballot announced

CHICAGO, August 27, 2009—A broad-based initiative, led by the National Quality Forum (NQF), announced the availability of a Health Level Seven (HL7) ballot that will advance automated performance measurement and reporting. Representatives from the NQF, American Health Information Management Association (AHIMA), Alschuler Associates, LLC, and HL7 worked together to engage critical stakeholders in standardizing the Health Quality Measure Format (HQMF) to enable effective implementation and use of performance measures in electronic environments.

The HQMF represents a health quality measure in a machine-readable electronic format. Through standardization of a measure's structure, metadata, definitions and logic, the HQMF provides quality measure consistency and unambiguous interpretation. A quality measure encoded in the HQMF format is referred to as an "eMeasure" and is a critical component of the workflow to support “meaningful use” of electronic records as described by the American Recovery and Reinvestment Act of 2009.

“This work will make it easier for physicians and other clinicians to monitor and evaluate the care they are providing patients based on data routinely captured during care processes,” said Floyd Eisenberg, NQF senior vice president of health information technology.  “This new format standard will enhance the use of nationally-recognized performance measures at the point of care to enable greater transparency for providers and consumers.”

Hospitals and other healthcare provider organizations typically have many different computer systems used for everything from billing records to patient tracking. Currently, new information is not consistently communicated across these systems. “We believe the HQMF will bridge an important gap in automated performance measurement,” said Crystal Kallem, AHIMA director of practice leadership and HQMF project manager. “Standardizing quality measure data elements and logic will streamline implementation of measures and reduce the burden of manual data collection and reporting.”

Development of the HL7 draft standard was spearheaded by Alschuler Associates, LLC, as part of an NQF contract with the Department of Health and Human Services to promote the effective use of electronic health records. “Our starting point in this design and development effort was consistency with the standards in use for electronic health records,” said Liora Alschuler, Principal at Alschuler Associates, LLC and co-chair of the HL7 Structured Documents Work Group. “eMeasure used in conjunction with template Clinical Document Architecture provides a powerful and coherent platform for many types of reporting requirements.”

The HQMF project coordinated pre-ballot discussions with a number of key stakeholders, including representatives from the American Medical Association, National Committee for Quality Assurance, HIMSS EHR Association, American College of Physicians, The Joint Commission, Child Health Corporation of America, Indiana Health Information Exchange, Allscripts, and GE Healthcare, among others.

As physicians and other clinicians are increasingly asked to participate in performance measurement programs, standardizing the implementation of nationally-recognized and endorsed quality measures will play an important role. Such standardization will be critical in making quality improvement efforts useful and meaningful for physicians and other clinicians and for improving the health of America’s patients.

HL7 invites the public to review and vote on the HQMF to ensure that a broad range of industry stakeholders’ interests is considered. The HQMF ballot package is now publicly available.

###

American Health Information Management Association represents more than 53,000 specially educated Health Information Management professionals in the United States and around the world.  AHIMA is committed to promoting and advocating for high-quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA’s enduring goal is quality healthcare through quality information. www.ahima.org

Alschuler Associates, LLC provides health information technology consulting and development services. The company’s mission is to make health information available across the spectrum of care, supporting safe, effective, affordable healthcare through comprehensive electronic records that sustain public health, quality reporting and research. www.alschulerassociates.com

About HL7 is the leading global authority on standards for interoperability of health information technology with members in 57 countries. Founded in 1987, HL7 is a not-for-profit, ANSI-accredited standards development organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. www.HL7.org