Health Quality Measures Format: eMeasures

This project was supported by volunteer efforts and through the National Quality Forum’s (NQF, www.qualityforum.org) contract with the U.S. Department of Health and Human Services to promote the effective use of Electronic Health Record (EHR) systems. The initiative aims to significantly improve the quality and efficiency of patient care by making possible the capture and reporting of quality measure information for physicians and other health care providers.

The NQF is a unique, multi-stakeholder, nonprofit organization dedicated to improving the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs.

NQF is also working with other organizations to assure that quality measure specifications can be uniformly incorporated into EHRs and reported to physicians and other clinicians for continuing quality improvement efforts at the point of care.

As physicians and other clinicians are asked to participate in more and more quality improvement and pay-for-performance programs, standardizing the implementation of NQF-endorsed performance measures will be critical in making quality improvement efforts useful and meaningful for physicians and other clinicians and for improving the health of patients.

The Collaborative for Performance Measure Integration with EHR Systems ("Collaborative"), co-sponsored by the American Medical Association (AMA) and the National Committee for Quality Assurance (NCQA) and Electronic Heath Record Association (EHRA), is a group of stakeholders in the physician performance measurement and quality improvement arena who have a shared goal to provide the industry with workable recommendations for performance measure use. The Collaborative’s goals are: [1] To create a standardized way of communicating Performance Measures; [2] To establish standards that permit structured, encoded Performance Measure information to be incorporated into EHR applications while preserving the clinical intent of the Performance Measure; and [3] To improve the process of Performance Measure update and maintenance for EHR vendors

The Collaborative developed the HQMF reference guide, a prototype to address performance measure functionality and integration with EHR systems. The HQMF prototype defined a standardized way of expressing performance measures while preserving the clinical intent of the measure itself. In spring 2009, NQF sponsored efforts to take the prototype HQMF and align it with HL7 constructs. This draft HL7 standard was produced through volunteer efforts and the Health Quality Measure Format (HQMF) project sponsored by the NQF.

The design of this specification was produced over the course of 22 sessions using an open and transparent process to ensure broad stakeholder input. The following individuals were instrumental in guiding the project so that alignment occurred between interested organizations:

• Chad Bennett, Iowa Foundation for Medical Care
• Kevin Coonan, Dana-Farber Cancer Institute
• Patty Craig, The Joint Commission
• Aaron Cutshall, Indiana Health Information Exchange
• Lori Fourquet, eHealth Sign
• Paul Fu, Illumisys
• Grahame Grieve, Kestral Computing Pty Ltd.
• William Goossen, Results 4 Care
• Kendra Hanley, American Medical Association
• Delane Heldt, American Medical Association
• Joy Kuhl, Child Health Corporation of America
• Austin Kreisler, Centers for Disease Control and Prevention
• Thom Kuhn, American College of Physicians
• Cecil Lynch, OntoReason, LLC
• Susan Matney, University of Utah Health Care
• Lloyd McKenzie, LM&A Consulting / HL7 Canada
• Greg Pawlson, National Committee for Quality Assurance
• Jacob Reider, Allscripts
• Phil Renner, National Committee for Quality Assurance
• Dan Russler, Oracle Corporation
• Harry Solomon, GE Healthcare
• David Stumpf, United Health
• Julie Thompson, Nationwide IT Services, Inc.
• Jim Unander, American Medical Association

The co-editors also express their appreciation for the support and sponsorship of the HL7 Structured Documents Working Group. We acknowledge the work on HL7 Version 3 and the Reference Information Model (RIM), and the contributions from HL7 domain committees, especially Clinical Decision Support, Patient Care, and Modeling and Methodology Working Groups.

Finally, we acknowledge the foundational work on the HQMF, initially a prototype of the Collaborative for Performance Measure Integration with EHR Systems (a collaborative of the American Medical Association, the National Committee for Quality Assurance, and the Electronic Health Records Association); and the RAND's work on a Performance Measure Reporting Language (PMRL) for representing performance measures in a computer-interpretable and sharable format.

This is a new document that is ballotted as a Draft Standard for Trial Use (DSTU) in the September 2009 ballot cycle. The DSTU Period for this document is two years.

No information is provided here because there is no content in this domain to navigate.