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| Either separate files or pointers to data within primary health records |
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| Usually separate databases created to track specific types of data like cancer tumors, implanted devices, or childhood immunizations |
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| Used for reporting performance (HEDIS, NHQM) |
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- Created manually in a paper system
- Created automatically in EHR system
- Used for both internal and external reporting purposes and studies
- Organized by various categories, such as disease, attending physician, surgeon, procedures, discharge status, patient’s age or zip code, and so on |
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| Permit healthcare organizations to locate, count, analyze data for quality and process improvement |
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- Allow quick identification and sorting of records for external reporting
- Allow automatic identification of records for abstracting for both internal or external registries |
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- Separate databases created to track specific types of data
- Available to either internal or external users
+Hospitals use to improve performance or processes
+May be required by outside sources for data reporting |
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| Facility quality assessment, research, measure success of various treatment modalities |
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| Aggregated and reported to state, national cancer registries; used to identify trends and changes |
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Points to medical record containing one or more fields to be reported or studied
Example: disease index includes all patients |
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- Created by NCQA as a tool by which it could compare quality of care patients receive under various health plans
- Consists of 71 measures across eight domains of care
- Allows employers to use results of NCQA reports to select best plan for employees
- NCQA has accreditation program for health plans
- NCQA collects HEDIS data directly from managed care HMO and PPO organizations
- Data transferred to IDSS in XML format and consists of secondary records
- Researchers may use HEDIS data to study trends
- Does not contain PHI |
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- Helps integrate outcomes and other performance measurement data into accreditation process
- Supports healthcare organizations in internal quality improvement efforts
- Standardized with CMS, allowing facility to collect and report same data set for both Joint Commission and CMS initiatives
Called National Hospital Quality Measures (NHQM) |
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- Predefined set of rules that helps break down complex processes into simple, repetitive steps
- Used to process data to arrive at desired result
- Used to select initial population in data sampling for the measure set |
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- Can be used to show the relationship between two different things
- Usually written as 2 numbers separated by colon, such as 9:1
- Formula: x/y = ratio |
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| Pay For Performance (P4P) |
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- New development by CMS and other payers
- Ties reimbursement to improvements in quality
+ Example: CMS’s Hospital Quality Initiative links reporting of NHQM to hospital payments for each discharge
- CMS also developing for physicians and nursing home care
+ Doctors who meet or exceed performance standards receive bonus payments |
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