HIT Standards CommitteeHIT Standards CommitteeQuality WorkgroupQuality Workgroup

Next Steps:Quality Measures for 2013

Janet Corrigan, ChairJanet Corrigan, ChairNational Quality Forum

Floyd EisenbergFloyd EisenbergNational Quality Forum

June 30, 2010

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Clinical Quality Workgroup Members

• Janet Corrigan, Chair, National Quality Forum• Floyd Eisenberg, National Quality Forum• John Derr, Golden Living, LLC• Judy Murphy, Aurora Health• Marc Overhage, Regenstrief• Rick Stephens, Boeing• James Walker, Geisinger• Jack Corley, Healthcare Information Technology

Standards Panel (HITSP)• John Halamka, Harvard Medical School • Walter Suarez, Kaiser Permanente

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Presentation at a Glance

• Update on Retooling of Potential 2011 MU Measures

• Results of the ONC Environmental Scan of Leading Health Systems

• Overview of NQF Fast Track Project

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Measure Retooling Update

• 44 Ambulatory Measures

• Use the Quality Data Set to identify data elements

• Apply logic in human readable format

• Provide lists of codes (value sets) for each data element

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ONC Environmental Scan

Scan of 12 leading healthcare systemsResponses from 9 organizations:• American Board of Family Medicine

• Geisinger Health System

• Mayo Clinic

• Kaiser Permanente

• Aurora Healthcare

• Tenet Healthcare

• Interim Healthcare

• PointRight

• National Association of Home Care and Hospice

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ONC Environmental Scan

Condition /

Cross-Cutting AreaPerformance Measure*

Diabetes HbA1c<7%

Diabetic Screen for Peripheral Neuropathy

Monitoring HbA1c and LDL in Patients with Diabetes

Tobacco use in Diabetic Patients

Preventive Services Breast Cancer Screening

Colon Cancer Screening Rate

Cervical Cancer Screening Rates

Flu Vaccination

Obesity Weight Management

Hypertension High Blood Pressure Yellow highlighting indicates the measure or a comparable measure is included in the set

delivered to HHS

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ONC Environmental Scan

Condition /Cross-Cutting Area Performance Measure

Healthcare Associated

Infections

Decrease Use of Urinary Indwelling Catheters in

Patients 65 and Older

SCIP-Inf-3 Prophylactic Antibiotics Discontinued Within

24 Hours After Surgery End Time

SCIP-Inf-9 Postoperative Urinary Catheter Removal on

Post-op Day 1 or 2

Safety Events Total Falls per 1,000 Patient Days

Appropriate Use of High Risk Medications

High-Risk Pressure Ulcer Prevention and Chronic Care

Medication Management Medication Compliance

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ONC Environmental Scan

Condition /Cross-Cutting Area Performance Measure

Patient experience HCAHPS Survey Scores

Staffing Nursing Staffing Ratio

Nursing Turnover Rates

Skilled Nursing Chronic Care (CC) Percent of residents who have

moderate to severe pain.Physical Restraints-Chronic Care (CC) Percent of residents with daily physical restraints.

Care Transition Re-hospitalization measures

Stratification of disposition based on discharge

assessment

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ONC Environmental Scan

Condition /Cross-Cutting Area Performance Measure

Home Care Acute Care Hospitalization after Home Health

Episodes of Care

Improvement in Management of Oral Medications

Stabilization in Self Grooming

Stabilization in Light Meal Preparation

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NQF Fast Track Project – Two Objectives

1. Identify “types of measures” that might be appropriate for 2013 with input from: • ONC Environmental scan of health systems• Comments on Potential MU11 Measures• Beacon Communities List of Measures• Gretsky Group• Other

2. Identify pathways to generate the desired types of measures within the requisite time frame:• Appropriate measures available• “Similar” measures available that might be adapted• Measures would need to be developed de novo

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Next Step

• NQF Report due July 2010• Intended to

o Inform Policy Committee’s September discussions aimed at identifying types of MU measures for 2013

o Identify time-sensitive measure development work that must get underway very quickly

o Input to Standards Committee’s Fall work aimed at identifying specific measures available to satisfy Policy Committee’s recommended measure types