In a comment letter submitted to AHRQ in response to its RFI on the convergence of health IT and clinical quality measures, CHIME urged the organization not to bite off more than the industry can chew. Specifically, that means accepting the fact that abstractors will remain part of the data collection process for some time, and must be empowered to do better work.
CHIME said, “The goal of 100 percent automation is an extremely long-term vision, given the state of natural language processing and the workflows of providers. We recommend that AHRQ look to develop practical ways that health IT can be used to aid current workflows and processes so that abstractors can more efficiently perform quality assurance and CQMs can increasingly be more meaningful.”
“While complete automation is a laudable goal, we believe the more pressing need is to make incremental advancements and disseminate best practices in the near-term,” the letter continued.
Pam McNutt, SVP/CIO at Dallas-based Methodist Health System, stated: “As part of AHRQ’s research, we believe they should focus on the kinds of technology and workflow processes that can support abstractors’ efforts to develop accurate clinical quality measures. Today’s quality measures evaluate process steps, not outcomes. Many of them are intermediate steps towards something that can truly describe the quality of care delivered.”
The overall challenge of reconciling disparate QM programs is frightful in and of itself, noted CHIME.
“The accurate reporting of electronic quality measures is one of the most daunting challenges faced by providers today,” the three-page letter to AHRQ Director Dr. Carolyn Clancy said. “Through our experiences with Meaningful Use and other quality reporting programs, we found that although EHR products were able to automatically produce CQM reports, the data was inaccurate, inconsistent and largely incomparable across different providers.”
An AHRQ-funded environmental study found that over 70 initiatives, spanning federal state and private-sector programs, are engaged in activities to realize potential benefits of health IT-enabled quality measurement. However, many of these initiatives are not harmonized, even within the same federal agency. “This has serious implications for provider workflows, resources and diminishes many of the gains sought by quality improvement proponents,” CHIME stated.
“CHIME has long advocated and commended efforts that strive towards harmonization among CQM reporting across all HHS agencies and programs,” said Jeffery Smith, Assistant Director of Advocacy for CHIME. “However, we believe such harmonization must extend through (1) the specific CQM, (2) how the CQM is reported, and (3) to whom it is reported.”