HEDIS Electronic Clinical Data System (ECDS) Reporting

For more information on the ECDS Initiative, please contact ECDS@NCQA.org or submit your question or concern through our PCS system.

Previous Events

NCQA hosted a virtual event to widely share the results of the HEDIS Learning Collaborative on February 23, 2017. During the event, panelists discussed the overall findings from the Learning Collaborative, including plans' experiences in collecting ECDS data and reporting on the depression measures.

Use the following link watch a recording of the event: 
https://www.youtube.com/watch?v=1OZOfOeE5G8

What is ECDS Reporting?

NCQA is piloting a new option for healthplan quality reporting in HEDIS – Measures Using Electronic Clinical Data Systems (ECDS) – which expands the use of electronic data for quality measurement. ECDS is intended to provide a roadmap towards high-value measurement by encouraging interoperability in the name of quality. Using quality reporting as a framework for advancing standardization of clinical system communications will ideally achieve increased data accuracy, timeliness of results and reduce the burden of reporting HEDIS measures.

For the ECDS pilot, we are repurposing the existing HEDIS framework towards more efficient use of electronic clinical data. Health plans are well positioned to build an ECDS infrastructure for quality reporting by expanding established relationships to include automated, bidirectional sharing of clinical quality information. Their capacity to track patient data across settings and health care providers, and their experience with data authentication will ensure that the electronic patient records used for quality reports accurately match patient experiences.

ECDS is one part of a larger NCQA strategic priority to increase the efficiency of the measurement process and the accuracy and specificity of measure calculations. Improving the accuracy and timeliness of quality results is inspiring this push for innovation in the HEDIS landscape.

What is an ECDS?

Electronic Clinical Data Systems (ECDS) are a network of data containing a plan member’s personal health information and records of their experiences within the healthcare system. ECDS may also support (directly or indirectly) other activities related to care through various interfaces that include evidence-based decision support, chronic disease management and outcome reporting. Data in ECDS are structured such that automated quality measurement queries can be consistently and reliably executed to provide results to the team responsible for the care of health plan members. Health plans that establish an enterprise network of interoperable ECDS will foster a member-centered, team-based approach to improving health care quality.

Core Principles of HEDIS ECDS Measures

NCQA is working with clinicians, system interoperability experts, NCQA-Certified EHR vendors, data analytic experts, NCQA-Certified auditors and other stakeholders to develop a clear framework for implementation of the HEDIS ECDS domain developed around three core principles to ensure that use of ECDS for HEDIS quality reporting will:

  1. Support appropriate access to electronic health data across the entire care continuum,
  2. Emphasize a member-centered, team-based approach to quality health care services, and
  3. Support a learning health system that encourages innovation.

NCQA is reviewing existing administrative, hybrid and medical record HEDIS technical specifications to determine which could be re-engineered to utilize the wealth of data available in ECDS. As we continue to focus on measurement areas of importance, we concurrently examine the potential value of other data that might enable future development of meaningful (high value) measures.

Questions regarding measures under consideration and the proposed schedule for inclusion in HEDIS ECDS may be directed to ecds@ncqa.org.

Types of ECDS Data

Organizations use multiple data sources to collect information about their membership and about delivery of health services to members. Data systems that may be eligible for HEDIS ECDS reporting include, but are not limited to, member eligibility files, EHRs, clinical registries, HIEs, administrative claims systems, electronic laboratory reports (ELR), electronic pharmacy systems, immunization information systems (IIS) and disease/case management registries. ECDS have a variety of formats.

  1. Structured data is health care data residing in discrete, static fields using internationally recognized vocabulary standards. These data are acceptable for ECDS reporting if they can be electronically extracted, transformed and loaded consistently and reliably to a data warehouse for downstream use in quality measurement.
  2. Semistructured data are acceptable for use in ECDS reporting if each data element conforms to a uniform semantic structure and prescribed hierarchy.
  3. Member-reported data from the legal health record is acceptable, whether reported to a disease- or case-management program clinician or as member responses to a standardized assessment, delivered in a structured form through a secure application programming interface (API).

Data Categories

ECDS measures are reported by each source system accessed for a measure result. Recognizing that member data may come from multiple locations, a hierarchy is applied to data found in multiple sources. Members are assigned to one category for each measure element (e.g., initial population, denominator, exclusions, numerator).

Each data source used for HEDIS is defined categorically using the following priority:

  1. Electronic health record (EHR). Real-time, patient-centered records that make information available instantly and securely to authorized users. EHRs eligible for this category of ECDS reporting include any vendor certified by the NCQA Measure Certification program, the NCQA eMeasure Certification program or any system that meets the 2015 Edition Base Electronic Health Record (EHR) definition
  2. Health information exchange (HIE)/clinical registry. HIEs and clinical registries eligible for this reporting category include state HIEs, immunization information systems (IIS), public health agency systems, regional HIEs (RHIO), Patient-Centered Data Homes™ or other registries developed for research or to support quality improvement and patient safety initiatives. Registries can be sponsored by a government agency, nonprofit organization, health care facility or private company, and decisions regarding use of the data in the registry are the responsibility of the registry’s governing committee.
  3. Case management registry. A shared database of member information collected by certified case managers through a collaborative process of member assessment, care planning, care coordination or monitoring of a member’s functional status and care experience. Case management systems eligible for this category of ECDS reporting include any system developed to support the organization’s case/disease management activities, including activities performed by delegates.
  4. Administrative claims. Includes only data from administrative claim processing systems for services incurred during the period defined by each measure’s Continuous Enrollment, and only services for which the reporting entity has paid or expects to pay.