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I've previously described the Beth Israel Deaconess Physician Organization's (BIDPO) decision to create a community registry for quality data warehousing in support of meaningful use.
As the project has progressed, we've made several decisions that I'd like to share.
What quality indicators will we store?
We've inventoried all the pay for performance reporting requirements of our local payers and crosswalked it with the 17 quality metrics required for meaningful use, as documented on the new HHS Blog.
In summary, the measures will include treatment process and outcomes data for:
Acute Bronchitis
Adverse drug events
Asthma
Cancer Screening
Cardiovascular Conditions
Depression
Diabetes
HIV
Hypertension
Immunizations
Lead Screening
Medical Home
Pediatrics
Pharyngitis
Reproductive Health
Substance Abuse
Surgery Patients
Tobacco
URI
Vital Signs
You'll find the details in this presentation.
Other decisions we've made include:
1. All our data content transfers from eClinicalWorks and our home built EHR will be done using the HITSP C32 implementation guide of CCD.
2. Transport will be done using the HITSP Service Collaboration 112, specifically using TLS with certificate exchange. We will use the NEHEN network (diagramed above) for routing from our EHR hosting site to the quality data center.
3. To protect confidentiality we will pseudonymise the data, separating identifiers from the data itself. BIDPO will be able to re-identify data for queries such as assembling quality measures from different data sources, but a breach of the registry itself will not release any patient identified information.
This project will enable us to implement and refine many of the standards recommended by HITSP and the HIT Standards Committee. I will continue to report experiences from our implementation efforts which I hope will be used to enhance the standards implementation guides.
John Halamka, MD, blogs regularly at Life As a Healthcare CIO.
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