To solve the perennial challenge of reporting clinical quality measures to myriad quality programs, more healthcare providers are using quality data warehouses to streamline their quality reporting efforts. It was at a HIT Policy Committee Meaningful Use Workgroup meeting last fall, where CIOs voiced this barrier, saying that one of the most valuable things the Centers for Medicare & Medicaid Services (CMS) could do was to harmonize all the programs to which providers must report quality measures.
Beth Israel Deaconess, a 621-bed teaching hospital of the Harvard Medical School, and the Adirondack Region Medical Home Pilot Program have both chosen to use quality reporting middle man Massachusetts eHealth Collaborative (MAeHC) Quality Data Center (QDC) to aggregate their data streams and report quality measures on their behalf.
MAeHC is a Waltham-based provider of EHR implementation and meaningful use services, strategy development and execution, and quality reporting services for healthcare organizations. The QDC is a software as a service (SaaS) product that received ONC-ATCB 2011/2012 Certification last November that extracts and aggregates data from multiple clinical systems for clinical quality measures analysis and for submission of meaningful use clinical quality measures. The QDC, which demonstrated at this year’s HIMSS conference, is certified for CMS’ Physician Quality Reporting System (PQRS), all 44 meaningful use Stage 1 clinical quality measures for eligible professionals, and can also do reporting for a variety of health plan quality programs.
“We chose the MAeHC QDC because we have several EHR vendors and needed unified analytics for our entire Pioneer Accountable Care Organization community,” says John Halamka, M.D., CIO, Beth Israel Deaconess. “We wanted to be nimble enough to keep pace with constantly evolving analytics needs.”
John Halamka, M.D.
Beth Israel Deaconess has a large employed and affiliated physician population of 1,800 clinicians. MAeHC extracts the inpatient care summaries housed in Beth Israel Deaconess’ homegrown EHR, Web Online Medical Record (WebOMR), and aggregates it with its affiliated physician practices’ ambulatory clinical data (from the Westborough, Mass.-based eClinicalWorks). The clinical information is then transmitted via the public HIE, New England Healthcare Exchange Network (NEHEN), to QDC.
“It’s an interesting model, and we may see more like this,” says Micky Tripathi, CEO, MAeHC. “You have a private organization, Beth Israel, using the public utility, NEHEN, to send data to their private agent, which is us, rather than building a proprietary interface to us.”
“There are so many quality measures whether its AQC [The Alternative Quality Contract from Blue Cross Blue Shield of Massachusetts], Pioneer ACO, PQRS, and pay for performance, so we simply feed a data summary from every encounter to the QDC via the information exchange, and they compute on our behalf all necessary quality analytics required by our government, payer, or others,” says Dr. Halamka.
The Adirondack Region Medical Home Pilot Program, which began in January 2010 as a $9 million joint initiative of medical providers and public and private insurers, also contracts with MAeHC for quality reporting. Organized into three geographic pods across the Adirondack North Country region, the program was designed to improve the care coordination and management of patients through a patient centered medical home (PCMH) model and the implementation of interoperable health IT. Last December, all of 31 primary care practices in that program were recognized as Level 3 Patient Centered Medical Homes– the highest level achievable—from the National Committee for Quality Assurance (NCQA).
The Adirondack Medical Home Pilot enlisted the support of the Massachusetts eHealth Collaborative when it was first awarded the HEAL NY Grant to help with EHR selection, implementation, adoption, and meaningful use reporting. "Meaningful use reporting is not a simple, straightforward process—the metrics are open to interpretation, and many of the metrics an organization might chose to report on are not directly supported by the EHRs built-in reporting capabilities," says Dennis Weaver, M.D., HEAL 10 program services director for the Adirondack Medical Home Pilot. "With the QDC we just upload our raw EHR data and they handle all of the aggregation, analytics and reporting, applying the latest reporting best practices as they go. It’s an excellent quality reporting tool for our Pilot.”
Tripathi adds that the Adirondack Medical Home Pilot has seven EHR vendors spread across more than 200 clinicians. “All of their data is coming to us through HIXNY, the Health Information Exchange New York, and we’re developing measures that we’re going to provide back to the seven health plans," says Tripathi. "Data goes back to care teams who are working with the practices to improve care and then going to the health plans who are going to fuel the payments they make to the patient-centered medical homes.”