ONC sees 10 years of quality improvement

Toward 'an electronically enabled QI ecosystem that promotes better health and care'
By Mike Miliard
11:17 AM

In tandem with its 10-year interoperability roadmap, ONC has developed a decade-long vision for ensuring health information technology is deployed to "enable robust and continuous quality improvement."

"Dramatic advancements have been made in digitizing the care delivery system during the past decade," ONC notes in its report – not least the fact that all 50 states have some form of health information exchange services to enable care coordination.

In addition, more than half of U.S. hospitals can electronically search for patient information outside their own walls, with six out of ten electronically exchanging health information with outside providers.

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Still, more can be done.

"ONC envisions an electronically enabled QI ecosystem that promotes better health and care, improved communication and transparency, rapid translation of knowledge for all stakeholders and reduction in the burden of data collection and reporting for providers," according to the study.

Toward that end, the agency has set goal posts at three-, six- and 10-year intervals.

Three years out: "Alignment and standardization to support data capture within the QI ecosystem"

Quality reporting programs must be better aligned, "to reduce the collection and reporting burden on providers and hospitals," ONC concedes.

"Through maturing standards, giving technical assistance, certifying health IT and coordination among federal and state agencies, ONC will work to harmonize and align measure components, tools and standards," according to the report. "Providers, payers and health systems need highly reliable, comparable and universally accepted performance indicators for priority health conditions and patient safety initiatives, such as preventable hospital readmissions and reduction of healthcare associated conditions."

Moreover, "stakeholders may have unique QI objectives on which they would like to focus," says ONC. "A key building block to enabling this wide variety of QI goals is the capture of highly structured, shareable data that has the appropriate level of metadata in place to support multiple uses: CDS, advanced analytics and quality measurement."

Six years out: "Big data for the QI ecosystem"

Over the next six years, as quality improvement data sharing increases. "quality and safety metrics will refocus from provider-centric to patient-centric," according to ONC. "The data in health IT, including patient-generated and claims data, will be standardized, linked at the individual level to clinical data as appropriate, and optimized for interoperable sharing and aggregation.

"Clinical data from heath IT will be increasingly structured, but will still require mapping and normalization to be aggregated and analyzed," according to the report. "Big data has the characteristics of high-volume, high-velocity and high-variety and will require effective and innovative analytic tools to filter out the 'noise' and yield useful information.

"For the purposes of performance measurement and improvement for value based payment, regional linking of claims and clinical data will enable measurement and reporting on quality and efficiency to all payers while providing timely feedback to providers on all their patients."

10 years out: "Fast data, fast improvement across the QI ecosystem"

A decade from now, ONC sees a rosy future for interoperability and data exchange, leading to markedly better care: "By 2024, the nationwide use of interoperable health IT will be pervasive. Patients and their care team will use quality and safety data and measurement as an expected aspect of care delivery. There will be numerous advancements in the features, functionality and interoperability of health IT tools that the QI ecosystem stakeholders seamlessly interact with on a daily basis for multiple purposes such as: healthy habits of daily living, delivery of care, care coordination, population management and value based reimbursement.

"Our citizens will enjoy better health, high-value and high-quality care, with improved safety and highly useable technologies and resources," ONC's report continues. "Individuals will view themselves as the hub of their health and care and will be considered an integral member of the care team. Technology will continue to advance and become more pervasive in every aspect of daily living. Individuals will routinely use advanced technology to manage and monitor their wellness and healthcare, and generate data for use by multiple IT systems and analytical tools.

"Their data will be available whenever and wherever they are needed to enable optimal health and care. They will enjoy personalized information and individualized care which is crucial to facilitate their wellness goals and the flow of their health information."

Read the full report here.

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