CAPT VERONICA GORDON, USPHS HEALTH INFORMATION EXCHANGE QUALITY EVALUATION PLAN WORK GROUP DEFENSE HEALTH AGENCY (DHA) - DOD Disclaimer: The opinions expressed in this presentation and on the following slides are solely those of the presenter and not necessarily those of the DHA/DoD.
AGENDA Data Data Exchange Health Information Exchange Quality associated with Health Data Exchange Quality Measures Measurement Challenge Lessons Learned Questions and Answers
DATA In relations to Healthcare What is Data? How do we use data? Where do we get data from? Where is data stored? Who wants the data and why? How much do we care about the quality of the data?
DATA EXCHANGE Information Data Knowledge
WISDOM!
HEALTH INFORMATION EXCHANGE (HIE) The Health Information Exchange (HIE) is the seamless and secure electronically sharing of vital health care data between: Network Providers Health care Professionals Health care Facilities Patients Federal Agencies such as SSA The intent of the HIE is to enhance patient care coordination, produce costefficiencies and increase quality of care
QUALITY ASSOCIATED WITH HEALTH DATA EXCHANGE Quality of care (QoC) is expected to be manifested by evidence of valued outcomes based on: Timeliness Accuracy Patient Safety QoC Accessibility
SECONDARY USE OF HIE DATA Secondary Use is often referred to as Re-Use of Data HIE may enable data already collected as part of a clinical use to be re-used for another secondary use case These Use Cases may be broken down into four distinct categories Research Industry Quality Reporting Public Health
QUALITY MEASURES Reduced medication and medical errors Complete medication profile (drugs and allergies) Complete Problem list Elimination of laborious paperwork and paper records Reduction in unnecessary duplicative lab tests Reduced exposure to radiation secondary to unnecessary duplicative radiographic procedures Reduction in preventable readmissions Enhanced patient care experience Improvement in health reporting and surveillance Increase in provider availability and time allowed for a patient to discuss health concerns and treatment
QUALITY MEASURES CONTINUED Technical Measures Metrics to measure how well the system is working in regards to performance, reliability, downtimes, break-fix, etc. Performance Metrics Transaction Metrics Usage Stats (Metrics) Clinical Measures Metrics to measure the value proposition of the HIE as it relates to quality of care, medical cost, and patient care outcomes. Cost (ROI) Metrics Quality Metrics Value (Effectiveness) Metrics Both sets of Measures will be needed for correlation
MEASUREMENT CHALLENGE According to recent studies and literature, even though billions of dollars have been spent on developing HIE technology there are no Standardized metrics used to evaluate its impact or return on investment (ROI) In addition, many health care organizations that have established robust HIEs, do not have established processes or plans to gauge its success Establishing a baseline of the Status Quo Promotion of Correlation Studies vs Cause and Effect
LESSONS LEARNED Quality Evaluation Planning Work Group Charter the workgroup early on to determine roles, responsibilities, and governance Establish a Business Plan that is complimentary to your organizations mission Identify stakeholders early in the development of a workgroup Qualitative measures vs Quantifiable measures Establish the status quo Innovative when selecting Data Sources to collect data Determine the most important metrics based on organizational requirements vs capability Focus on the what not the how Then, determine feasibility of the selected metrics Establish a comprehensive marketing campaign to substantiate the significance of measuring the data exchange
Q & A
REFERENCES Websites: http://www.healthit.gov/ http://healthit.ahrq.gov/health-it-tools-and-resources/health-information-exchangehie-evaluation-toolkit Book: Medical Informatics: An Executive Primer (Second Edition). HIMSS 2011 Edited by Ken Ong, MD, MPH ISBN: 978-0-9844577-0-0