1. NCQA’s Approach to the New Quality Measurement Landscape
Ben Hamlin
NCQA

2. Quality Measurement Advancing Interoperability
Transforming Quality Measurement to QI
Introduction
HEDIS ECDS
NCQA eMeasure Certification
Digital Measure Collaborative
Today I will be giving a brief overview of a few activities that will effect some change in the quality measurement landscape.
First I will discuss the new HEDIS ECDS reporting standard intended to support wider use of electronic data for HEDIS reporting.
Next I will provide an overview of how NCQA is validating eCQMs improve the precision of the data and processes used for eCQM submissions
Finally I will discuss a new collaborative which represents our commitment to sharing innovative ideas and promoting wider adoption of best practices in the digital measurement space.

3. Use of Electronic Clinical Data Systems
HEDIS ECDS

4. What Does Interoperability Mean?
Accessibility & Usability

5. Electronic Clinical Data Systems (ECDS)
Network of health information records within the healthcare system
Improve Communication
Integrate Essential Data
Through direct engagement and collaboration across the care continuum
Support Access
So many organizations can participate, not just the fully wired
With emphasis on a patient-centered, team-based approach to quality
Confidential - Do Not Distribute

6. Electronic Clinical Data Systems (ECDS)
Accelerating Innovation, Increasing Value
Harmonize
Specifications across programs and w/decision support
Standardize
Incorporate data from multiple systems - requires uniform layouts
Integrate
Incentivize effective sharing of electronic clinical information
Confidential - Do Not Distribute

7. ECDS measures are reported by each data source accessed
HEDIS ECDS Update for 2018
Modifications to the framework for ECDS Reporting
ECDS measures are reported by each data source accessed
1) Electronic health record (EHR)
-A hierarchy is used as guidance in cases where a member’s data are in multiple locations
2) Health Information Exchange / Clinical Registry
3) Case Management Registry
4) Administrative Claims
Confidential - Do Not Distribute

8. Stakeholder Outreach
Use of Electronic Clinical Data Systems
Outreach to stakeholders to discuss ECDS and implementation strategy and implications
Discussions included:
Diversion of resources from existing programs to build pipelines to share data
Value proposition for payers:
efficiency and innovation of method as incentive
New opportunities for :
data stewards
registries

9. ECDS
A future of effective data management

10. eMeasure Certification: Validating Logic for eCQMs

11. Health Plan Data Repository
Certified eCQM data can be integrated into a health plan’s data repository and used as data for performance measurement reporting.

12. QRDA Category I and III Reports
Output Files
Category I
Category III
reports aggregated quality measure data
reports raw patient- level data about a single patient

13. Testing includes…
Ensuring that the measure-specific software code extracts the correct electronic clinical data defined in the eCQM specifications
Initial Patient Population (IPP)
Denominator logic
Numerator logic
Exclusion/Exception logic
Ability to report the extracted clinical information in the standard document format called Quality Reporting Document Architecture (QRDA)

14. Programs Used to Generate Decks
CCD Files
The text files generated in the BlackCase program are then converted into a CCD file for each patient.
Uses SAL to determine every decision point.
Case prototypes based on the different decision points are created for each patients.
Decision Points
Test Patients
Data is assigned to each prototype case in order to define the specific characteristics of each patient.
Test patient data is generated in text files.
BlackPath Program
BlackCase Program
BlackCCD Program

15. Digital Measure Collaborative

16. Digital Measure Collaborative
Community Best Practices Supporting NCQA Measure Programs
Joint effort between NCQA and its stakeholders :
open forum for the exchange of ideas and innovative solutions
provide access to NCQA digital measure resources that use clinically relevant information from multiple sources
new research and the latest techniques for aggregating electronic clinical data for quality measure reporting

17. The Digital Measures Collaborative
Advance reporting digital quality measures
Ease labor and financial burdens 
More reliable and useful measures 
Create measures to digital formats 
Increase the value of data
Manual chart reviews are time consuming and costly
Measure more
Measure better
Reuse data

18. Using common standards
The Digital Measures Collaborative
How do we accomplish this?
Using common standards
Quality Data Model (QDM)
Electronic Clinical Data Systems (ECDS)
Clinical Quality Language (CQL)
Fast Healthcare Interoperability Resources (FHIR)
and peer-problem solving