Are You Ready for Digital Measures?
Viewpoints of quality measures can evoke images of coding value sets, manual chart reviews or perhaps even excel spreadsheets. While these mental images may not necessarily be incorrect, they do fail to capture the technology side of the situation by neglecting how health data is captured – digitally.
Most healthcare organizations and teams want less burdensome quality reporting, but many don’t have the systems in place to be prepared for more efficient ways. To be successful in the fast-moving world of value-based care, healthcare organizations and teams need to be attentive to industry changes. Are you ready for Digital Quality Measures (dQM)?
Say Hello to Digitally-based Quality Measures . . .
It isn’t just the dynamics of provider workflows that have shifted with the transition to electronic documentation but the entire system for how health care is delivered, monitored, and improved. In the past, teams read a quality measure definition, and each had to make their own interpretation of what the concepts meant. This led to misconceptions, inconsistent coding and ultimately undermined the ability to compare performance across care settings.
With digital quality measurement, the future looks bright because it overcomes obstacles teams have experienced in the past with trying to manually interpret measure codes. Technically speaking, digital measures are measures that have specifications that are represented by Fast Healthcare Interoperability Resources (FHIR) and Clinical Quality Language (CQL) standards. In plain English, digital measures reduce ambiguity by using codes that allow both health care professionals and computer systems to understand the intent of the clinical concepts used in quality measures.
. . . And goodbye to Electronic Clinical Quality Measures?
Well, not so fast. For the past few years, we’ve seen the adoption of quality measures that use Electronic Health Record (EHR) data, also known as Electronic Clinical Quality Measures (eCQMs), as a basis of numerous value-based programs across sectors. What then is the difference between eCQMs and dQMs? Simply, dQMs are more comprehensive in that they are written in a data-source agnostic manner. Meaning dQMs take data from multiple electronic sources whereas eCQMs were built to reflect performance based on EHR data. The below diagram illustrates how dQMs are the next evolution of quality by reflecting the numerous-electronic-system health care industry we work in today.
Digital – The Latest Industry Trend
If there’s one catchphrase for any national healthcare organization right now, it’s digital quality system. If you’re not keeping a pulse on all the discussion, you may be left behind. Let’s do a quick review of some of the other digital-first initiatives we are seeing out there:
- NCQA’s Electronic Clinical Data System (ECDS) Reporting Type is a subtype of dQMs. All ECDS measures are digital, but not all dQMs are ECDS. They ease the reporting burden by using data from EHRs, registries, HIEs and other digital sources. In a previous blog we discussed how with more holistic quality measures comes more complex quality measurement. This NCQA issue brief does a nice job of summarizing the current status of ECDS adoption.
- NCQA’s Data Aggregator Validation (DAV) program validates that data aggregators (i.e. HIEs, health systems, accountable care organizations, etc.) that collect electronic health data maintains the data integrity in order for the data to be used as HEDIS® standard supplemental data. This program has the potential to reduce reporting burdens in a significant way while also providing the opportunity for more valid data to support care management and population health activities. As a DAV first-cohort participant, we’ve been sharing our knowledge and learnings in this resource center.
- CMS’s Reimagined Quality System is signalling commitment to provider burden reduction through dQMs with announcing the goal of 100% of quality measures being digital by 2030.
Now more than ever, rethinking the way we measure, monitor, and improve the quality of health care should be of the upmost importance to those looking to change the system. The move to dQMs as part of a broader digital quality strategy serves as a key tenant to creating a more effective health care system. As the evolution continues with national organizations, don’t wait until these measures are mandated so you can have the best chance at success with your value-based contracts.
About the Author
Director of Quality Programs at KPI Ninja, Inc.
Renee provides operational leadership of quality initiatives at KPI Ninja. Towne has a background in occupational therapy, education and experience in operational excellence across a variety of healthcare domains. Based on prior experience as a clinician that drove outcomes patient by patient, she is leaving a larger footprint by improving health care more comprehensively, population by population.
About KPI Ninja
KPI Ninja is a data analytics company that helps healthcare organizations accelerate their quality, safety, and financial goals with a unique combination of software and service. We are differentiated by our signature mix of technology, performance management consulting and healthcare expertise. We don’t merely offer software solutions but work shoulder to shoulder with clients to help them draw on the power of analytics and continuous improvement methodologies to become more efficient. In harmony with our data-centered ethos, we truly believe that our success is strongly co-related with yours.