1. HIT Standards Committee Quality Workgroup Next Steps: Quality Measures for 2013 Janet Corrigan, Chair National Quality Forum Floyd Eisenberg National Quality Forum June 30, 2010

2. 2 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

3. 3 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

4. 4 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

5. 5 ONC Environmental Scan Scan of 12 leading healthcare systems Responses 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

6. 6 ONC Environmental Scan Condition / Cross-Cutting AreaPerformance Measure* DiabetesHbA1c<7% Diabetic Screen for Peripheral Neuropathy Monitoring HbA1c and LDL in Patients with Diabetes Tobacco use in Diabetic Patients Preventive ServicesBreast Cancer Screening Colon Cancer Screening Rate Cervical Cancer Screening Rates Flu Vaccination ObesityWeight Management HypertensionHigh Blood Pressure Yellow highlighting indicates the measure or a comparable measure is included in the set delivered to HHS

7. 7 ONC Environmental Scan Condition / Cross-Cutting AreaPerformance 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 EventsTotal Falls per 1,000 Patient Days Appropriate Use of High Risk Medications High-Risk Pressure Ulcer Prevention and Chronic Care Medication ManagementMedication Compliance

8. 8 ONC Environmental Scan Condition / Cross-Cutting AreaPerformance Measure Patient experienceHCAHPS Survey Scores StaffingNursing 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 TransitionRe-hospitalization measures Stratification of disposition based on discharge assessment

9. 9 ONC Environmental Scan Condition / Cross-Cutting AreaPerformance 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

10. 10 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

11. 11 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