Even before healthcare providers begin to demonstrate the first set of meaningful use requirements next year, federal health IT policymakers are already working on how high to set the bar for providers to qualify for the next round of financial incentive payments in 2013.
One set of criteria – that providers show the use of health IT to achieve healthcare quality outcomes – will appear in progressively more sophisticated stages. A tenet of meaningful use, quality measures are expected ultimately to help providers both hone their treatment protocols and lower healthcare costs.
The National Quality Forum (NQF), a performance improvement organization, is looking at several sources of quality data from which to identify categories of measurement and to weigh the readiness of providers.
NQF work to help policymaking
The results of the "fast track" NQF project will help inform discussions by the federal Health IT Policy and Standards committees when it takes up future quality measures in September, according to Janet Corrigan, chairwoman of the committee's clinical quality work group and the chief executive of NFQ.
"As we look to 2013 and 2015, ideally we would want to look across the full longitudinal care episodes," said Corrigan. "In 2011, all our measures are siloed and not across settings," she said at a standards committee meeting June 30.
For instance, providers should not only look at readmissions in their own facility but across the community and patient outcomes and total cost of care over six months or 12 months, she said.
By showing how they track selected meaningful use quality measures to improve outcomes, such as measuring the reduction in hypertension through periodic blood pressure testing, providers will qualify for incentive payments under the HITECH Act.
To gauge what types of future measures may be more useful than others, NQF is combing through comments that the public made in response to the proposed meaningful use rule from the Centers for Medicare and Medicaid Services.
Beacon Communities have also started to assemble a list of measures that focus on particular conditions, such as diabetes, "which all the communities have identified as one they want to push on," Corrigan said.
The Office of the National Coordinator awarded grants to 15 communities around the country where adoption of electronic health records is substantially under way and can serve as models for other locales.
NQF also has conducted a survey of the quality measures that nine healthcare systems, including Geisinger Health System and Mayo Clinic, monitor. In addition to measures tracking diabetes, hypertension and obesity, which are already included in the proposed 2011 meaningful use measures, these health systems are highlighting measures to reduce hospital-based infections and enhance patient safety and accurate medication management, she said.
NQF also has sponsored a discussion group, called the Gretsky Group, named for the ice hockey great Wayne Gretsky, "to think about where the puck is going in 2015 and then work back to 2013 measures," Corrigan said.