Performance Measurement Data Element Structured for EHR Extraction
White paper: Performance Measurement Data Element Structured for EHR Extraction
- Tuesday, July 22, comment resolution was completed. Detailed comments are located at:
Discussion on various sections and comments, tasks
- 18 June 2008 Version 1.0 for Public Comment
- 14 May 2008 QRPH_Technical_Committee_Minutes_2008-05-14
- 1 May 2008 QRPH_Technical_Committee_Minutes_2008-05-01
- 30 Apr 2008 Agenda / Minutes of 10:00 - 11:00 AM (CDT US) White Paper Update Call
- 23 Apr 2008 Discussion: Potential Coordination with work of the Collaborative for Performance Measure Integration with EHRS
Previous work (versions)
- ITI Sharing Value Sets Profile
- Collaborative for Performance Measure Integration with EHR Systems XML Schema Reference Guide
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.
- Measure specific information for two exemplars:
- Acute Myocardial Infarcton Measure - ACEI / ARB Prescribed at Discharge - Joint Commission