Introduction and Welcome:

Nancie McAnaugh, MSWCenter for Health PolicyMO HIT Assistance Center

Presenter:

Noelle ParkerMissouri Quality Improvement Network Team ManagerMissouri Primary Care Association

Tracking Clinical Quality Measures

MO HIT Assistance CenterMissouri’s Federally-designated Regional Extension Center

University of Missouri: Department of Health Management and Informatics Center for Health Policy Department of Family and Community Medicine Missouri School of Journalism

Partners: Hospital Industry Data Institute (Critical Access Hospitals) Missouri Primary Care Association Missouri Telehealth Network Primaris

Assist Missouri's health care providers in using electronic health records to improve the access and quality of health services; to reduce inefficiencies and avoidable costs; and to optimize the health outcomes of Missourians

Vision

For providers who do not have a certified EHR system - We help you choose and implement one in your office

For providers who already have a system - We help eligible providers meet the Medicare or Medicaid criteria for incentive payments

4

What is our role?

Cerner and the University of Missouri Health System have an independent strategic alliance to provide unique support for the Tiger Institute for Health Innovation, a collaborative venture to promote innovative health care solutions to drive down cost and dramatically increase quality of care for the state of Missouri. The Missouri Health Information Technology Assistance Center at the University of Missouri, however, is vendor neutral in its support of the adoption and implementation of EMRs by health care providers in Missouri as they move toward meaningful use.

Disclosures

This regional extension center is funded through an award from the Office of the National Coordinator for Health Information Technology, Department of Health and Human Services Award Number 90RC0039/01

Tracking Quality Measures

To introduce you to the value of tracking quality measures

To explain the origins of NQF quality measures

To explain how this helps attain meaningful use criteria

Provide Roadmap and Words of Wisdom

Objectives

Clinical Data Maturity Model

Adoption

Quality of Data Equals the Quality of Care Delivered

Quality Improvement

Accountable Care Management

Population BasedPatient BasedEncounter Based

Ref: Arcadia Solutions

VALUE OF TRACKING QUALITY MEASURES

Clinical outcome Measurable Trackable A clinical quality measure is a mechanism

used for assessing the degree to which a provider competently and safely delivers clinical services that are appropriate for the patient in an optimal timeframe.1

1Retrived from: http://www.qualitymeasures.ahrq.gov/about/inclusion-criteria.aspx

What is a Clinical Quality Measure

Safety - patients should not be harmed by the care that is intended to help them

Patient-Centered – Patient care should be based on individual needs and driven by the patient

Timely - waits and delays in care should be reduced

Effective - care should be evidence-based Efficient - reduce waste Equitable - care should be equal for all people

quality attributes

Improve healthcare for patients and population based on valid data measured and reported over time

Data helps demonstrate how quality healthcare is delivered, obtained and sustained

Improve overall healthcare of an individual and/or a population by using evidence based medicine

They help improve the quality of healthcare by setting priorities and goals for performance improvement

Drive Healthcare Change across the nation/international

Help to identify gaps in patient care populations (cervical cancer screening)

Value….

Process: a measure that focus on a process which leads to certain outcome, meaning that a scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a certain outcome.

Outcome: A measure that indicates a result of the performance (or nonperformance) of a function or a process. 1

Types of measures used in MU

1Retrived from: http://www.qualitymeasures.ahrq.gov/about/inclusion-criteria.aspx

ORIGINS OF NQF MEASURES…

National Quality Forum (NQF) measures are at the center of MU These measures help to improve

quality by1. Bringing together experts in the field

to define quality with uniform standards

2. Report and analyze where there are gaps in quality

3. Caregivers use theses measures to improve, measures, and report

Measures accredited by:

Important to measure- Measuring something that will make a difference in healthcare of a

population, where the evidence is the highest measurement that can have a positive impact on healthcare quality. i.e. Preventive Care & Screening Measure Pair for Tobacco Use and Cessation Intervention

Scientifically Acceptable- When measures are implemented they will produce reliable and valid

results. i.e Preventive Care & Screening Measure. Useable and relevant-

Asking the right questions to the right audience. Not ask a 2 year old if they smoke, might ask parents if there is 2nd hand smoke exposure.

Asking questions that will drive change Multiple stakeholders finds value in tracking the measures and

outcomes Feasible-

Data is readily available and retrievable without undue burden

NQF measuresValue

Standardization across measures Provides central benchmarking Best Practices

Allows you to compare your measures with local, state, and national standards

Prioritizes Health Care initiatives Focus on the most important conditions

Compare apples to apples within any EHR system.

Common goal to improve quality of health care

The benefits of using NQF measures:

HOW DO QUALITY MEASURES RELATE TO MEANINGFUL USE

Use of certified EHR technology for electronic exchange of health information to improve quality of health care

Use of EHR to submit clinical quality and public health measures

Use of EHR in a meaningful manner to improve patient care and safety

Meaningful Use goals

Stage 1- Data Capture – “get your feet wet” Improve quality, safety, efficiency, and reduce

health disparities Engage patients and families Improve care coordination Protect privacy and security of personal health info Improve population and public health

Stage 2- Data Aggregation – Validate and generate data

Stage 3- Data used to impact Outcomes – make informed decisions based on authenticated data

Adoption Stages of Meaningful Use

(NQF 0013)Hypertension: Blood Pressure Management

(NQF 0028 a & b)Tobacco use assessment & tobacco cessation intervention

(NQF 0421)Adult weight screening and follow-up

3 Core CQM Measures

ROAD MAP TO TRACKING AND REPORTING QUALITY MEASURES

• Develop team, project plan and schedule meetings

Planning

• Identify metrics that currently don’t meet standards

Current State Assessment

• Meet with key staff to identify the root cause for the gap

Root Cause Analysis

• Determine the most effective actions to address the gap

Identify remediation strategies

• Create a plan and timeline to reduce gaps, and execute

Plan and Execute

• Continuous quality improvement checkpoints

Review and remediate

Strategy for tracking measures

Create the right team Start small Engage everyone Validate data

Data capture reflects quality of care provided

Communication at all levels Leadership buy-in and support Patient focused Create a plan and follow it

Be patient, the road is long

and slow… This is a journey Persistence pays off Change agent needed to drive

change Embrace change Think outside the box and

don’t take “no” for an answer from your vendor

Hold everyone accountable Standardize and Document

Words of Wisdom

Noelle Parker- nparker@mo-pca.org

Missouri Primary Care Association3325 Emerald LaneJefferson City, MO 65109-6879(573) 636-4222www.mo-pca.org

Contact Information

Questions?

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Privacy & SecurityWednesday, October 12th

Presenter:Becky Thurmond FowlerUniversity of MissouriDivision of Information Technology,

Information Security & Access Management

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