Digital Quality Measures in Action—A Progress Report

(#3 in a series of 4 blogs that preview Track 2 of the 2021 Digital Quality Summit sessions) 

In Session 4, I will join Emily Morden, NCQA Director, Electronic Clinical Measurement, to discuss the digital quality ecosystem and the state and direction of digital quality measures (dQM)—specifically, HEDIS^® measures. We’ll explore why interoperability is important to modern quality operations, including the recently finalized rules by CMS and ONC, and how it ties in with dQMs. 

We’ll present new stats and survey results on dQM uptake by health plans and vendors; armed with fresh data, we’ll get the first insights into the latest HEDIS reporting results (submitted in June). 

Emily will give an update on the state of dQMs and upcoming HEDIS measures, and explain how HEDIS is evolving to support greater use of structured electronic clinical data—and how all dQMs are moving to the FHIR-CQL standard for MY 2022. She’ll also share qualitative findings on adoption of measures that leverage clinical data and anecdotal feedback from health plans.  

And we’ll answer these questions: 

· What’s the value and opportunity? 

· What are the challenges? 

· How can we address challenges? 

The idea behind operating models for dQMs is a standardized, high-level framework for measure data processes. Operating models let us put current and future data operations into a common model and plot the transition to standardized, structured data and streamlined operations. Each model has two basic components: 

1. The Data Flow: How data flows from different sources into a quality reporting system or platform, and how that platform calculates and reports quality metrics. 

2. The Validation Chain: How data is validated and audited to ensure accuracy and clear attribution to a valid source (aka “data provenance”). 

We’ll also talk about the impact of interoperability rules, standards and technologies on payer data operations for HEDIS and other important payer use cases. 

By the end of Track 2, we’ll have clarified the “big picture” of what digital quality operations look like, why they’re important and how measure authors, payers and vendors can move forward to put dQMs into action. 

Additional Resources 

The Transition to an All-Digital Quality Measure Ecosystem (ncqa.org) 

Making dQMs Work—An Overview of Operating Models (ncqa.org) 

NCQA > HEDIS MY 2022 Digital Measures Bundle 

Community Questions 

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