Measurement’s Digital Future is Already Feasible

You don’t have to be an informaticist to appreciate a new study three NCQA colleagues co-authored in the Journal of the American Medical Informatics Association.

The study’s title is Harnessing electronic clinical data to report adult and prenatal immunization quality measures.

The study matters because:

  1. It shows plans can successfully report HEDIS measures using NCQA’s newest reporting format—Electronic Clinical Data Systems (ECDS).
  2. ECDS reporting is a vital part of the next-generation digital measurement ecosystem.
  3. The study features a focus on immunization measures—always an important quality topic.

A Vital Intersection: Immunization and ECDS

To understand the study’s significance, it helps to first understand why:

  • Immunization measures matter.
    Immunizations are arguably the most important tool in the public health toolkit.Yet immunization rates are lagging, as shown by past research.

The 2016 federal National Adult Immunization Plan cites quality measures as an important way to monitor and improve vaccination rates.

  • Immunization measures are well suited to be reported using electronic clinical data sources.People receive vaccinations many places—at their doctor’s office, their local pharmacy, even at work.

    Health plans are in a good position to aggregate information about all that vaccination activity. The question is how plans can collect and report what they know.

In addition to using claims data, plans can make connections to sources like immunization information systems. Those repositories exist to record and securely share information on peoples’ vaccination history.

And that’s where ECDS comes in: It is a reporting method that encourages the use and sharing of electronic clinical data to help improve patient care.

ECDS’ Desirability

To further understand why we’re excited about the new study, consider what ECDS is and why it exists.

ECDS is:

  • A structured way to collect and report electronic clinical data found in claims, electronic health records, case management systems, registries and health information exchanges.
  • An automated alternative to manual review of medical records.

NCQA introduced ECDS as a reporting method for several new measures in 2014.

To work as HEDIS ECDS reporting, data must:

  • Use standard layouts.
  • Meet technical specifications.
  • Be accessible to the care team upon request.

Benefits of ECDS include:

  • More insight into patient care.
  • More patient-specific care.
  • Alignment with value-based payment
  • Reduced measurement burden.

Overall, ECDS is a way to get to better measures.

ECDS’ Feasibility

ECDS is desirable. But is it doable for most organizations?

To answer that question, the new study focused on the feasibility of ECDS reporting.

Researchers assessed how many plans successfully used electronic clinical data beyond claims to report rates on two immunization measures: Adult Immunization Status (AIS) and Prenatal Immunization Status (PRS).

Results showed that health plans are seeking information beyond claims to assess immunization coverage. Almost half of Medicaid and Medicare plans used data sources such as registries and EHRs to find information about their members’ immunizations; nearly 80% of commercial plans did so.

More on ECDS

ECDS is a frequent topic in our Future of HEDIS webinar series and in discussions of digital quality in our Quality Innovation Series.

We encourage anyone interested in quality measurement’s digital future to read the study. The paper has intriguing comparisons and details we don’t have space for here.

The authors conclude, “The electronic data connections demonstrated by the HEDIS immunization measures, while nascent, are critical to the improvement of patient care and long overdue.

As former National Coordinator for Health Information Technology, David Blumenthal, has said, “Information is the lifeblood of modern medicine. Health information technology is destined to be its circulatory system.”

This study is an encouraging sign that ECDS reporting could become an important part of health care’s circulatory system.