Frequently Asked Questions
are currently in development.
- What is ECDS?
Electronic Clinical Data Systems (ECDS) are databases 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, quality management and outcome reporting. Data in ECDS are structured such that automated quality measurement queries can be consistently and reliably executed and provide results to the team responsible for the care of health plan members.
- How are ECDS measures different from the eMeasures in Meaningful Use?
While the measure descriptions, names and other elements may look very similar, eClinical Quality Measures (eCQMs) developed for Meaningful Use are designed specifically for use by providers and/or hospitals whereas ECDS measures for HEDIS reporting are specified for use at the payer/system level of reporting. Measures must be specifically tailored to each of these unique settings in order to ensure the measure results appropriately reflect quality of care for each intended use.
- How is data for ECDS different from Supplemental data?
Unlike supplemental data currently used in HEDIS, data in ECDS are expected to be used to idenitfy eligible members for all elements of the measure specification. The primary source of data may be the same in many cases, however ECDS measures adhere to different reporting rules than those in the HEDIS EOC domain.
- Will ECDS measures be used for Health Plan Accreditation or rankings?
ECDS measures are currently classified as "First Year" measures by NCQA which means they are not eligible for public reporting, use in accreditation or health plan ratings. All NCQA measures must first be approved for public reporting by the Committee on Performance Measurement (CPM) before they can be considered for use in any NCQA program.
- Can claims be used for ECDS reporting?
Administrative claims may be considered ECDS if the payment system is automated and are accessible by the practitioner or practitioner group that is accountable for the clinical services provided to the healthplan member (e.g., if claims are used to identify a member's inpatient stay, the member's primary care provider must be notified of the event). If administrative claims systems are used to report ECDS measures, these members must also be included in the ECDS Coverage Rate (Rate 1) numerator.
- What is the ECDS Coverage Rate (Rate 1) threshold for public reporting of ECDS measure results (e.g., 50%, 70%, 90%)?
NCQA will not publically report ECDS Coverage rates. This information is for internal analytical use for benchmarking to inform the criteria necessary to allow eventual public reporting ECDS measure results.
- What existing HEDIS measures are going to be re-specified for ECDS?
NCQA is evaluating both existing HEDIS measures, eCQMs and other denovo measure concepts for inclusion in the HEDIS ECDS domain. Measures that are selected will be systematically reengineered and retested, when necessary, for ECDS and must be approved by the Committee on Performance Measurement prior to their release in the ECDS domain.
- What does “information has to be accessible by the healthcare team at the point of care" mean?
To qualify for an ECDS measure, any data used for the HEDIS ECDS report must be accessible by the healthcare team at the point of care (i.e., EHR generated quality reports, electronic portals, or automatically generated fax notifications). NCQA is not currently specifying a method of access, however a core principle of ECDS reporting is that the information needed to successfully deliver the highest quality care must be available to the entire healthcare team responsible for managing a member's health.
- What happens when the plan has ECDS from a primary care provider but the numerator data is collected by a specialist who is not using ECDS?
The member would be included in the numerator for ECDS coverage rate (Rate 1) and would not be included in the numerator for Rate 2, unless the specialist was entering their clinical findings into a registry that met the core requirements for ECDS reporting. Several tools for tracking patient progress are available for free download (e.g., https://aims.uw.edu/resource-library/excel%C2%AE-patient-tracking-template).
- What file formats are acceptable for transmission of data between the plan and the point of service?
NCQA is not currently specifying file formats for exchange of clinical information, however is strongly encouraging adherence to the Health Level Seven International (HL7) structured document standards for comprehensive quality data (e.g., QRDA, CCD).
- Does all data used to determine if a member is compliant with the denominator, numerator or exclusion have to come from an ECDS or can data from multiple sources be used?
Transactional data from a number of ECDS can be used for measure reporting as long as it meets the key eligibility criteria for ECDS reporting. Information on allowable data sources can be found at: http://www.ncqa.org/HEDISQualityMeasurement/ECDS/AllowableData.aspx.
- Who determines whether the data “qualifies” to be used for ECDS reporting?
Plans can either review the systems with their NCQA-certified auditor or requests for clarification on eligible systems can be sent to firstname.lastname@example.org.
- How do EHR vendors submit data and to whom does the submission file go?
Only health plans are eligible to submit ECDS measure results to NCQA. NCQA is currently certifying EHR vendors to report eMeasures in order to enhance health IT data use in providing detailed information on health care performance.
- Is there a mechanism to test ECDS files prior to submission?
A software certification platform for ECDS is currently in development. The program will closely align with current Mesures certification requirements for HEDIS EOC reporting.
- How do vendors get the ECDS technical specifications for the submission file format, etc?
HEDIS ECDS technical specifications include a sample expression of the measure logic in the HL7 Clinical Quality Language-based Health Quality Measure Format (V3IG: CQL-based HQMF R1). HEDIS ECDS measures include a measure logic template for each section of the technical specification (where applicable). Complete digital measure packages for HEDIS ECDS measures will be released by NCQA at a future date, however at this time we are only publishing a template within each section of the ECDS technical specifications found in Volume 2 as a reference.
- If a plan would like to use its internal case management system as a data source, must there be evidence that the data was shared with the provider?
The system must be able to be verified by an NCQA-Certified auditor that all healthcare providers responsible for managing the member's condition have access to the information. There are currently no specifications as to how the provider should access the information or how frequently in order to count for ECDS Coverage.
- If case management data resides solely within the plan and not shared with the PCP, can it be used as a supplemental data source for the numerator?
No, ECDS measures do not follow the same rules as measures in other domains that use supplemental data. While the initial source may be the same, data used to report any element of an ECDS measure must be accessible by all members of the healthcare team (which includes the PCP).