“We’re always seeking to participate in innovative strategies to see how it works in the States and, if possible, apply best practices here in Puerto Rico,” says Natalia Diaz, Quality Analytics Manager at Triple S Advantage, Blue Cross Blue Shield of Puerto Rico.
Triple S, a Medicare Advantage plan, was the only health plan in Puerto Rico that participated in an innovative learning collaborative with NCQA. They joined 13 other plans in working with NCQA to develop a new method for reporting Healthcare Effectiveness Data and Information Set (HEDIS) measures using data from electronic clinical data systems (ECDS).
Being a Pilot Participant has its Pluses
Pilot participants reported depression measure data. One challenge was leveraging data from multiple sources and unstructured fields and integrating it for reporting at the plan level. About their experience, Natalia said, “We learned about the importance of receiving structured data and that we still have a long way to go to electronically capture all the components needed for quality measurement.”
The pilot was a window into the benefits of electronic data collection. “We could be less invasive in physician’s offices, a faster way to have information in our hands and not have to physically visit physician’s offices to complete medical record review with a hard-copy medical chart.”
Innovations in Data Collection
Natalia says taking part in the learning collaborative lets them know what to expect with ECDS in the future, “This will ensure more precise information with increased data accuracy, updated information from our members, member profiles—tracking preventive screenings and chronic conditions to help members achieve their health goals and prevent comorbidities.”
Better for Health Plans, Practices and Patients
In the end, Natalia says ECDS will help provide better care for Triple S’ health plan members, and make it easier for practices, too, “They’re going to feel comfortable completing all the preventive screenings to our members and our members are going to have healthier lives.”
Dr. Mary Barton, Vice President of Performance Measurement at NCQA, moderated a learning collaborative Google Hangout discussion that included Natalia and other participating health plans. Watch the hangout here: https://youtu.be/1OZOfOeE5G8.