Health IT, feedback can raise quality of care

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Providing feedback loops, as recommended by the Institute of Medicine, was a core recommendation in the pre-rulemaking report of the Measure Applications Partnership (MAP).

The public-private partnership, convened by the National Quality Forum to make recommendations to the U.S. Department of Health & Human Services, called feedback the best way to determine whether measurement is being used in the way it was intended.

"Ideally, the exchange of information through feedback loops is systematic, standardized, real-time, two-way, occurs among all levels of the system, and takes best advantage of information technology," the report states.

In its second set of recommendations on which evaluation measures should be used in future rulemaking, the group examined more than 500 measures under consideration for 20 federal programs covering clinician, hospital and post-acute care/long-term care settings. It examined 366 quality measures in 2012.

This year, MAP gave the thumb's-up to 141 of them, and supported another 166, contingent on further development, testing or NQF endorsement, reports Government Health IT.

Meanwhile, MAP declined to support 165 measures under consideration, and recommended that 64 current measures be phased out. It also added six measures that HHS had not been considering.

"MAP's recommendations are meant to promote the selection of measures that will drive improvement for those providing care, transparency for those seeking care, and value for those paying for care," Elizabeth McGlynn, Ph.D., co-chair of the MAP Coordinating Committee, said in an announcement.

MAP previously recommended that the measure sets for Medicare Shared Savings Program (MSSP) and the Medicare Advantage 5-Star Quality Rating System be aligned. It strongly reiterated this recommendation during this pre-rulemaking cycle due to the high rate at which health IT is being adopted. That calls for aligned incentives across programs, the group argues. It also suggested alignment of MSSP and Meaningful Use measures.

As health IT becomes more effective and interoperable, the report says, measures should focus on a demonstrated and meaningful impact on care, such as:

  • Measures that reflect efficiency in data collection and reporting through the use of health IT.
  • Measures that leverage health IT capabilities, such as measures that require data from multiple settings/providers, longitudinal data, patient-reported data, or connectivity across platforms to be fully operational.
  • Innovative measures made possible by the use of health IT.

It also recommended reaching out to developers, including EHR vendors, to tackle gaps in measurement.

The National Quality Forum over the past year has released an array of quality measures, including those aimed at preventable harm, cancer, critical care and population health

To learn more:
- find the report
- here's the Government Health IT article
- read the announcement

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