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Thursday, February 16, 2012

Clinical Quality Workgroup

Today was my first call as a member of the Clinical Quality Workgroup of the HIT Standards Committee.  This work group is chartered with:
  • Recommending technical standards for eMeasures
  • Recommendations for Managing the Quality Measure lifecycle.
  • Improving Usability and Integration of quality measures into healthcare processes.
  • Suggesting how to link e-Measures with Clinical Decision Support
  • Identifying Responsible Stewards for eMeasures and their components
Much of today's discussion in the workgroup was around our charter, and the eMeasure life-cycle depicted below.

This looks a bit like a waterfall development model.  I raised the issue that quality measurement really needs to be built-in with the definition of the process (the clinical guideline) whose outcome you are trying to measure.  A number of other work group members echoed my concerns.

One of the members of the workgroup pointed out that the current processes for developing quality measures today are developed around the abstracting paradigm, and that when you re-architect them to support an EHR-based paradigm, the definition of what you are measuring will likely change.  Both measures might achieve the same objective, but would not necessarily be comparable.

An issue that we didn't get to talk about was how this workgroup, or HITSC would better communicate it's needs around quality measures to the relevant SDOs which are actively working in this area. Fortunately, those organizations are very well represented by members of the workgroup, including HL7, NQF, S&I Framework/Query Health, IHE, ISO, and others.

The workgroup is dividing up into two tiger teams.   One is tactical, and that is where much of the work I've been doing on Query Health and HQMF applies.  The other is strategic, and really focused on the overall process, which is where I have a great deal of interest.  As the ONC rep put it, you can be on as many as you like, just remember that you are the one who will be aware of the impact it has on your calendar.

Oh well, I guess that anything worth doing, is probably worth being double-booked for.

    Keith

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