FAQ Directory: HEDIS

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11.15.2017 Transitions of Care The HEDIS 2018 Volume 2 Technical Update memo indicates the following change in the Transitions of Care specifications: In the first sentence of the third paragraph, replace “date/time” with “date.”
Should this change also apply to the first bullet in the “Note” section of the technical specifications that reads, “The following notations or examples of documentation do not count as numerator compliant:
*Documentation of notification that does not include a time frame or date/time stamp.”

Yes. Replace the reference to “date/time” in the first bullet in the Note section with “date.”

HEDIS 2018

10.15.2017 ECDS Are we required to collect and report the source vendor for the data e.g., by vendor)and source system of record (e.g., EHR, HIE, case management, claims) when reporting ECDS categories?

Details about the data vendor or source EHR system are not required for ECDS reporting, but should be documented in the HEDIS Roadmap when identifying data sources for an NCQA-Certified auditor. Use of data from NCQA eCQM-Certified vendors will ensure that measure data extracted from these systems are considered standard.
ECDS data should be categorized by one of the four source record categories stated in ECDS General Guideline 2: Data Collection Methods (EHR, HIE/clinical registry, case management registry, administrative claims).

HEDIS 2018

10.15.2017 ECDS May we use depression screening performed by case managers who are employees of a health plan and are not part of an external provider group directly serving the member?

Yes. Data collected by care/case managers employed by a health plan are appropriate, and are reported in the Case Management category in the measure report.

Care/case managers are considered part of the member’s care team because they help members manage a condition and/or their use of health care services.

HEDIS 2018

10.15.2017 ECDS How are ECDS different from supplemental data?

The ECDS reporting method uses much of the same data classified as supplemental for other HEDIS measures, but ECDS measures adhere to different reporting rules from those in other HEDIS domains. Unlike supplemental data used for HEDIS, data for ECDS reporting are classified by source and are used to report all measure elements (e.g., denominator, exclusions, numerator).

HEDIS 2018

10.15.2017 ECDS For IP-ECDS coverage, does NCQA look for the number of members in the initial population?

IP-ECDS coverage count includes all members in the initial population who are being managed by at least one provider with the capacity to send, receive and use electronic data for quality improvement purposes.The Initial Population includes all members (covered and not covered by ECDS) who are identified as eligible for the measure reported by the data source category used to determine eligibility.

HEDIS 2018

10.15.2017 ECDS How do vendors get the ECDS technical specifications for the submission file format?

HEDIS ECDS technical specifications are available in the NCQA store in PDF format: http://store.ncqa.org/index.php/catalog/product/view/id/2822/s/hedis-2018-volume-2-measures-for-electronic-clinical-data-systems/. They are also available in HEDIS 2018 Technical Specifications for Health Plans, which can be purchased at the NCQA store.

Complete digital measure packages for HEDIS ECDS measures will be available for download at a future date.

HEDIS 2018

10.15.2017 ECDS Does the denominator only include plan members covered by ECDS who are in the initial population?

Yes. The denominator should be all members covered by ECDS who do not meet exclusion criteria.

HEDIS 2018

10.15.2017 ECDS What does NCQA mean by “information has to be accessible by the health care team at the point of care”?

To qualify for HEDIS ECDS reporting, practitioners and practitioner groups that are accountable for clinical services provided to members must have access to data used by plans for quality measure reporting, regardless of the SSoR.

NCQA does not currently specify a method of data access, but a core principle of ECDS reporting is that the information needed to deliver the highest-quality care must be available to the entire health care team responsible for managing a member’s health.

Qualifying modes of access may be as simple as a provider’s phone request for member information, or as sophisticated as an integrated decision support system. The care team’s ability to access data must be documented, to provide evidence that information is available whether or not it is accessed.

HEDIS 2018

10.15.2017 ECDS What is the IP-ECDS Coverage Rate threshold for public reporting of ECDS measure results?

Organizations do not report an IP-ECDS coverage rate; they report a count of members in the initial population covered by ECDS. NCQA does not publicly report these data, which are for internal NCQA use and for benchmarking analysis to help determine the timeline for public reporting.

HEDIS 2018

10.15.2017 ECDS Who determines that data “qualify” for ECDS reporting?

Refer to the ECDS general guidelines for information. Request clarification through the NCQA Policy Clarification Support (PCS) system at https://my.ncqa.org or review the proposed systems with your NCQA-Certified auditor. Send requests for individual technical support with ECDS reporting to ecds@ncqa.org.

HEDIS 2018

10.15.2017 ECDS What file formats are acceptable for transmitting data between the plan and the care team at the point of service?

NCQA does not specify file formats for exchanging clinical information, but strongly encourages adherence to Health Level Seven International (HL7) standards for clinical document exchange (e.g., QRDA, CCD) and electronic health care information exchange (e.g., FHIR).

HEDIS 2018

10.15.2017 ECDS If case management information resides solely within the plan and is not shared with the PCP, may it be used as a supplemental data source for the numerator?

Case management data that are available to the PCP on request meet the requirement for use in ECDS reporting.

Supplemental data may not be used for any part of an ECDS measure unless it meets all ECDS requirements.

HEDIS 2018