Pathways to Quality through Health Information Technology (Maryland)

Project Final Report (PDF, 3.94 MB)

Project Details - Ended

Project Categories

Summary:

Historically, quality measurement has relied on data collected from electronic claims, manual chart reviews, and patient surveys. With the increase in adoption of health information technology (IT) the ability to more efficiently collect data for quality measurement has improved, allowing for the development of new measures and increased integration of quality measurement and improvement. Although health care stakeholders agree on a number of recurring ideals for health IT-enabled quality measurement, stakeholders prioritize them differently.

This project sought to identify obstacles to improving quality through health IT by developing a report that characterizes an ideal future health information infrastructure for actionable and prioritized national quality measurement and reporting.

The specific objectives of this project were to:

  • Develop a background report on the current state of quality measurement through health IT and relevant initiatives in health IT and quality measurement. 
  • Gather stakeholder input on gaps in resources and knowledge in health IT and quality measurement. 
  • Develop a final report. 

Early in the project, the team developed and published Environmental Snapshot—Quality Measurement Enabled by Health IT: Overview, Possibilities, and Challenges (PDF, 2.87 MB). This report presented the then-current state of health IT-enabled quality measurement; presented elements of the next generation of quality measurement as identified in the literature; identified gaps in knowledge; and presented ways to achieve the ideal future state.

Following its publication the project team developed questions for a request for information (RFI) release to examine stakeholder perspectives on the key issues and challenges to achieving the next generation of quality measurement. AHRQ received 63 responses to the RFI, with representation from a variety of stakeholders including measure developers, providers and associations representing providers, vendors and organizations representing vendors, health plans and payers, and consumer-oriented organizations.

The project team analyzed the RFI responses to determine trends, challenges, and practical solutions for the near-term (1-to-2 years) and mid-term (3-to-5 years). The findings were used to frame and develop questions for six stakeholder focus group sessions that were held in 2013. Five of the focus groups were stakeholder-specific, representing each of the following groups: measure developers, payers, providers, consumers, and vendors. The sixth group was a cross-stakeholder group that discussed common and consistent issues as well as areas of divergence between groups.

Four primary perspectives were synthesized from the RFI responses and focus groups: 1) the highest priority of quality measurement should be accelerating systemic quality improvement; 2) measurement should leverage all currently available health IT necessary but should minimize implementation burden by being constrained to information generally available and widely accessible; 3) measurement should be a byproduct of care delivery and minimize the impact on clinician workflow; and 4) there should be central prioritization of measures, with new measurement priorities being driven by an authoritative entity that explicitly manages the other perspectives.

In addition, the RFI respondents and focus group participants identified several topics as essential building blocks for improving health IT-enabled quality measurement. These included the categories of measure development, implementation, and testing; data elements and data capture and tools to process unstructured data; data access, sharing, aggregation, and integration; patient engagement; and collaboration and education.

Findings were published in a report, Health IT-Enabled Quality Measurement: Perspectives, Pathways, and Practical Guidance (PDF, 1.67 MB). Its purpose is to share information, stimulate discussion, assist communication among stakeholders, facilitate understanding, and provide guidance on potential infrastructure enhancements that could be pursued individually or collectively. The report contains 111 specific recommendations in the areas of measure development, implementation, and testing; data elements and data capture and tools to process unstructured data; data access, sharing, aggregation, and integration; patient engagement; collaboration and education; and other topics and recommendations. Five appendices in the report summarize the input from the RFI and focus groups, and catalog the efforts of many organizations that are engaged in efforts to improve quality through health IT.

Pathways to Quality through Health Information Technology - 2012

Summary Highlights

  • Principal Investigator: 
  • Organization: 
  • Funding Mechanism: 
    Health IT Contract
  • Contract Number: 
    290-09-00024I-4
  • Project Period: 
    September 2011 – September 2013
  • AHRQ Funding Amount: 
    $1,168,918
  • PDF Version: 
    (PDF, 199.19 KB)

Summary: Recent legislative initiatives and new care delivery approaches have highlighted the importance of timely, targeted quality metrics, and the essential role of a robust and supportive information infrastructure. Signifi cant progress has been made in understanding the requirements, capabilities, and best practices of such information systems. However, the sharp increase in initiatives to integrate measurement of health care quality and health information technology (IT) underscore that gaps in knowledge persist.

AHRQ’s longstanding investment in building the evidence base on quality measurement through health IT is exemplified by the Ambulatory Safety and Quality Enabling Quality Measurement funding opportunity announcement, which supported innovative demonstrations, approaches, and methodological work. To continue such efforts, AHRQ seeks to further understand trends in health IT-related health care quality measurement that describe near-term (1-2 years) requirements, mid-term (3-5 years) issues, and issues that must be addressed.

To this end, this project will engage in activities such as asking for public comments through a request for information and holding focus groups with experts and key stakeholder groups to articulate current obstacles to improving quality through health IT. This will inform a key deliverable of the project— the fi nal report—that will attempt to characterize an ideal future health information infrastructure for actionable and prioritized national quality measurement and reporting.

Project Objectives:

  • Develop a background report on the current state of quality measurement through health IT andrelevant initiatives in health IT and quality measurement. (Achieved)
  • Gather stakeholder input on gaps in resources and knowledge in health IT and quality measurement. (Ongoing)
  • Develop a final report (Upcoming)

2012 Activities: Staff completed background research and published an Environmental Snapshot—Quality Measurement Enabled by Health IT: Overview, Possibilities, and Challenges, (PDF, 1.7 MB) which reported on the current state of health IT-enabled quality measurement, articulated some broad elements of the next generation of quality measurement identified in current literature, and identified gaps in knowledge and ways to achieve the ideal future state.

Staff developed a request for information (RFI) to examine stakeholder perspectives on some of the identifi ed key issues and challenges to achieving the next generation of quality measurement. AHRQ received 63 responses to the RFI, including representation from a variety of stakeholders such as measure developers, providers, and associations representing providers, vendors, payers, and consumer-oriented organizations. Staff analyzed the RFI responses to determine trends, challenges, and practical solutions for the near- and mid-term.

Results are being used to frame and develop questions for six stakeholder focus group sessions in 2013. Five focus groups will be stakeholder-specific to include no more than nine participants representing each of the following groups: measure developers, payers, providers, consumers, and vendors. Questions will be tailored to evoke issues and possible solutions from each group’s particular perspective. A final cross-stakeholder group will discuss common and consistent issues, as well as areas of divergence that arose in the stakeholder-specific groups.

Preliminary Impact and Findings: The project has no findings to date.

Target Population: General

Strategic Goal: To develop and disseminate health IT evidence and evidence-based tools to improve health care decisionmaking through the use of integrated data and knowledge management.

Business Goal: Knowledge Creation

Pathways to Quality through Health IT - 2011

Summary Highlights

  • Principal Investigator: 
  • Organization: 
  • Funding Mechanism: 
    Task Order
  • Contract Number: 
    290-20-0900024-1
  • Project Period: 
    September 2011 - September 2013
  • AHRQ Funding Amount: 
    $1,168,918
  • PDF Version: 
    (PDF, 165.46 KB)

Summary: Recent legislative initiatives and new care delivery approaches have highlighted the importance of timely, targeted quality metrics, and the essential role of a robust and supportive information infrastructure. Significant progress has been made in understanding the requirements, capabilities, and best practices of such information systems. However, the sharp increase in initiatives to integrate measurement of health care quality and health information technology (IT) underscore that gaps in knowledge persist.

AHRQ's longstanding investment in building the evidence base on quality measurement through health IT is exemplified by funding opportunities such as the Ambulatory Safety and Quality: Enabling Quality Measurement funding opportunity announcement, which has supported innovative demonstrations, approaches, and methodological work. To continue these efforts, AHRQ seeks to develop a well-informed strategic plan to improve health care quality measurement through health IT that describes near-term (3-4 years) resource requirements, longer-term (5-7 years) issues, and subjects that must be addressed.

To this end, this project will engage in activities such as asking for public comments through a request for information and holding focus groups with experts and key stakeholder groups to articulate current obstacles to improving quality through health IT. This will inform a key deliverable of the project-the final report-that will attempt to characterize an ideal future health information infrastructure for actionable and prioritized national quality measurement and reporting.

Project Objectives:

  • Develop a background report on the current state of quality measurement through health IT and relevant initiatives in health IT and quality measurement. (Ongoing)
  • Gather stakeholder input on gaps in resources and knowledge in health IT and quality measurement. (Ongoing)
  • Develop a final report. (Upcoming)

2011 Activities: During 2011, staff held the project kick-off meeting and submitted a work plan, project schedule, and a draft background report outline. Stakeholder engagement pre-work was initiated. It was determined that there was no need for institutional review board approval.

Preliminary Impact and Findings: This project has no findings to date.

Target Population: General

Strategic Goal: To develop and disseminate health IT evidence and evidence-based tools to improve health care decisionmaking through the use of integrated data and knowledge management.

Business Goal: Knowledge Creation

Health IT-enabled quality measurement: perspectives, pathways, and practical guidance.

Citation:
Roper RA, Anderson KM, Marsh CA, Flemming AC. Health IT-enabled quality measurement: perspectives, pathways, and practical guidance. (Prepared by Booz Allen Hamilton, under Contract No. 290-09-00024I-4.) AHRQ Publication No. 13-0059-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2013. (PDF, 3.94 MB)
Principal Investigator: 
Document Type: 

Quality measurement enabled by health IT: overview, possibilities, and challenges.

Citation:
Anderson KM, Marsh CA, Flemming AC, et al. Quality measurement enabled by health IT: overview, possibilities, and challenges. (Prepared by Booz Allen Hamilton, under Contract No. 290-09-00024I-4.) AHRQ Publication No. 12-0061-EF. Rockville, MD: Agency for Healthcare Research and Quality. July 2012. (PDF, 1.67 MB)
Principal Investigator: 
Document Type: 
Research Method: 
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