Performance Measurement Data Element Structured for EHR Extraction

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Current work

White paper: Performance Measurement Data Element Structured for EHR Extraction

Discussion on various sections and comments, tasks

Previous work (versions)

April 26, 2008

Related materials

Comments from Vassil Peytchev on Collaborative for Performance Measure Integration with EHR Systems

  • The goal of the Collaborative is to create a standardized way to communicate performance measures using structured, encoded performance measure information, which can be also used within EHR applications.

There are three levels of performance measures representation:

  • Performance measure description
  • Performance measure template
  • Performance measure machine processable information

This holds a resemblance to the levels of a CDA document:

  • Level 1 - Unstructured text
  • Level 2 - Structured text
  • Level 3 - Discrete data

The CDA is patient-centric, so it is not directly applicable here.

  • However, HL7 just published a draft for the SDA (Structured Document Architecture) which is not patient-centric, and can be directly applicable for this use. The Structured Document committee of HL7 is also working on a Quality Reporting Document Architecture (QRDA).
  • These intersecting activities strongly suggest that collaboration is the best way forward given the emphasis on HL7 CDA and CCD-based (and therefore HL7 V3 based) specifications throughout the US (HISTP, CCHIT), and internationally (IHE).

The Collaborative can consider the following notes about the Performance Measure Integration specifications:

  • The use of HL7 V3 data types when applicable. This will make the XML representation (of codes in particular)uniform across a variety of data exchange requirements.
  • Make use of the IHE processes. The IHE SVS profile, for example, will use a very similar structure to the CodeGroup and Code structure to represent contents of general value sets (using HL7 v3 datatypes).
  • Consider the use of the HL7 SDA as a basis for a performance measure description. This will allow for a future expandability of the format.
  • Reconsider the use of XML in the template for logical expressions.

A transformation of the XML content to a more readable form would be preferred.