Upload
keith-jensen
View
58
Download
0
Tags:
Embed Size (px)
DESCRIPTION
HL7 Quality Reporting Document Architecture DSTU. CDA Release 2, US Realm. Pele Yu, MD MS FAAP. HL7 September 2008 WGM (Vancouver, BC, Canada). Quality Reporting Document Architecture. - PowerPoint PPT Presentation
Citation preview
HL7 Quality Reporting Document Architecture DSTU
CDA Release 2, US Realm
HL7 September 2008 WGM (Vancouver, BC, Canada)
Pele Yu, MD MS FAAP
To develop an electronic data standard for exchange
of patient-level quality measurement data between healthcare information systems.
Quality Reporting Document Architecture
www.kidsquality.org
Paper Medical Records
Electronic Health Records Proprietary data
formats
Status Quo in Quality Measure Reporting
Data Entry100% manual process:
data abstraction and data mining
Prepare data
for analysis
Requestors of Quality Data
QualityImprovementOrganizations
AccreditingOrganizations,
Medical Societies, The
Alliance
Payers
Key-boarding or manual entry
Feedback to clinicians
Complete?
QRDA
Point of Care clinicians
Future of Quality Measure Reporting
www.kidsquality.org
Coordination with Related Efforts
Measure Development
eMeasure Specification
Aggregators, Requestors
ok?ok? ok?
The Collaborative eMeasure specification
NQF, NCQA, AMA, APQ.... Measure definition
HIMSS IHE: Multi-party choreography using HL7 messages, services
AH
IC,
HIT
SP
Use
Cas
es
QRDA QRDA QRDA
feedback
Data Elements for Quality
HITEP
QRDA Project History
• Phase 1: September 07 – January 08– Proof of concept, use CDA for quality reporting
• HAI reports for CDC (SDTC)• SDTC interest in CDA based non-clinical reporting
documents – Structured Documents Architecture (SDA)– Domain Analysis– Requirements Analysis
• Phase 2: May 2008 to present– DSTU Ballot – QRDA Implementation Guideline for 2 Pediatric
Measures (CHCA)– QRDA Reporting Categories (MedAllies)
• NHIN Trial Implementation demonstration project in NY• Summary patient record exchange using CDA
QRDA Draft Standard 2008
• Category 1 – Patient-Level Reports– For DSTU Ballot
• Category 2 – Summary Reports– Informational, for Comments
• Category 3 – Calculated Reports– Informational, for Comments
QRDA Category 1 Specifications• Header
– Header• US Realm• Unique CDA template ID, LOINC code, and Title
– Participants• Target a single patient• Author one or more entities (person, organization, device)• Informant one reporting entity (person, organization)• Custodian one custodian (person, organization)• Legal Authenticator one legal authenticator (person, organization)
• Body– One body– One or more sections, subsections (Measure Set, Measure)
• Section– Measure Set Section (measure set name, version, OID, description)– Measure Section (measure name, version, OID, description)– Reporting Parameters Section (applicable reporting period)– Patient Data Section (Re-use of CCD and CDA, if applicable)
QRDA Specifications – RIM Constructs
• Header– Header
• US Realm• Unique CDA template ID, LOINC code, and Title
– Participants• Target a single patient• Author one or more entities (person, organization, device)• Informant one reporting entity (person, organization)• Custodian one custodian (person, organization)• Legal Authenticator one legal authenticator (person, organization)
• Body– One body– One or more sections, subsections (Measure Set, Measure)
• Section– Measure Set Section (measure set name, version, OID, description)– Measure Section (measure name, version, OID, description)– Reporting Parameters Section (applicable reporting period)– Patient Data Section (Re-use of CCD and CDA, if applicable)
QRDA P
hase
1
QRDA Deliverable
• Implementation Guides for QRDA Category 1 Pediatric Measures– VON Neonatal Admission Hypothermia Measure
• Outcome measure
– CHCA Body Mass Index (BMI)• Process measure
• Rationale– Few data points, well-defined– Pilot potential– Pediatric measures on NQF Roadmap– Relevant to project stakeholder (CHCA)
Implication of DSTU• QRDA is feasible
– RIM adaptable– CDA adaptable– Strong HL7 support– Industry awareness achieved
• Ready for industry use– HITSP– IHE– Pilot efforts
• Barriers for adoption and progress– Lack of continuity in effort– Lack of formal project management structure
Next Steps
• QRDA DSTU Ballot reconciliation next few months– Resolve issues without substantive change and publish DSTU, or– Resolve issues w/ substantive changes, then re-ballot– Implications
• QRDA Phase 3– Funding for future development to refine DSTU leading to
Normative Standard• Category 1 DSTU• Category 2 and 3 include in next ballot cycle/s, if enough work is
done (MedAllies, etc)
– Create solid links with industry• Harmonize efforts (IHE, Collaborative, JCAHO, HEDIS, etc)• Engage vendors and MDOs
– Pilot and demonstration projects• Vendors, hospitals, QIOs