What is ECDS?
Electronic clinical data systems (ECDS) are databases containing health plan members’ personal health information and records of their experiences in the health care system. ECDS data may also support other activities through evidence-based decision support, quality management, outcome reporting and other ways. Data in ECDS are structured to ensure that automated quality measurement queries can be consistently and reliably executed and provide results to the care team.
How are ECDS measures different from the eMeasures in meaningful use, and how are they aligned?
Although the measure descriptions, names and other elements may look similar, Electronic Clinical Quality Measures (eCQMs) originally developed for the Centers for Medicare & Medicaid Services EHR Incentive Program (i.e., Meaningful Use) are designed for eligible providers or hospitals. HEDIS® ECDS measures are designed for the payer or health system level of reporting. Measures must be tailored to each unique setting to ensure that results reflect quality of care accurately for each intended use.
HEDIS ECDS measure specifications are written using the same standards (Quality Data Model, Clinical Quality Language) as eCQMs used in programs such as CMS MIPS in order to support reporting alignment. Measure alignment is of great interest to NCQA, as well as other key stakeholders. NCQA is committed to working across programs with our federal, state and other partners to promote alignment and develop the building blocks that will help us get there.
Does ECDS reporting use claims?
Yes, administrative claims are considered an administrative data source for ECDS reporting if the administrative claims can be accessed by the care team.
How is data for ECDS different from supplemental data?
ECDS measures incorporate many of the data sources that are considered “supplemental” for traditional HEDIS reporting. For example, immunization information systems data are considered “supplemental data” for traditional HEDIS, but they are classified as “Registry” for ECDS reporting. In addition, unlike supplemental data used in traditional HEDIS reporting, ECDS data can be used to identify any element of a measure’s specification (e.g., identifying the eligible population). Although the primary source of data may often be the same, ECDS measures have specific guidelines for how data are categorized for reporting.
Will the rules for Supplemental Data change for Traditional HEDIS Reporting?
Currently, there are no plans to change the way supplemental data are defined and used for traditional reporting. NCQA will continue to review and make changes as needed.
What does “accessible at the point of care” mean?
A core principle of ECDS reporting is that the information needed to successfully deliver the highest-quality care must be available (e.g., through EHR-generated quality reports, electronic portals or automatically generated fax notifications) to the health care team responsible for managing a member’s health. For ECDS measures, performance data should be available to care teams. Organizations meet this requirement if they are able to provide the requested information (e.g., phone, secure email, direct feed, provider portal, file request) to providers who are treating their members. Organizations should have documented processes for tracking these requests to be reviewed as part of the HEDIS audit.
How is data transmitted between the plan and the point of care?
NCQA does not specify a file format for exchange of clinical information but encourages adherence to the Health Level Seven International (HL7) structured document standards for comprehensive quality data (e.g., QRDA, CCD).
Who determines whether a system “qualifies”?
Plans should review data systems with their NCQA-certified auditor or ask questions through MyNCQA.
If a plan uses its internal case management system as a data source, does it need evidence it shared data with the provider?
The system must be verified by an NCQA-Certified auditor that the information can be accessed by all health care providers responsible for managing the member’s condition. NCQA does not specify how providers access the information, or how frequently.
ECDS Measure Use
Will ECDS measures be used for health plan accreditation or health plan ratings?
ECDS measures have not been added to NCQA’s accreditation or health plan rating programs as of this date. NCQA is working with our advisory panels and other stakeholders to continuously assess the ECDS measures for use in our evaluation programs.
Will traditional HEDIS measures be respecified for ECDS?
For measurement year 2019, NCQA added the ECDS reporting method to three existing HEDIS measures: Breast Cancer Screening, Colorectal Cancer Screening and Follow-up Care for Children Prescribed ADHD Medication. The ECDS method is optional but provides health plans an opportunity to report using the ECDS method for existing measures. NCQA expects to learn from these three measures as we assess other measures for ECDS.
ECDS Measure programming
How do vendors and plans get the ECDS technical specifications?
HEDIS ECDS measures include a basic description of the measure logic for each section of the technical specification (where applicable), which can be found in HEDIS Volume 2: Technical Specifications. Complete digital measure packages for HEDIS ECDS measures are available for download from the NCQA Store. These digital packages will need to be referenced to program the HEDIS ECDS measures.
Are vendors and plans required to consume machine-readable specifications or can they manually program their own code?
No, vendors and plans can manually program digital measures by referencing the provided logic files in the digital specification download package. They are not required to be able to automatically ‘ingest’ the executable files. For traditional HEDIS measures that have a digital specification available, vendors and plans can also still reference the narrative specification that is published in Volume 2. For the ECDS measures, there is no narrative version of the measure that can be referenced for programming. Vendors and plans will need to reference the provided logic in the digital specification download package.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).