Quality Roadmap

Scope and Current Work

There is ongoing work in several parts of the healthcare community today to incorporate quality guidelines into clinical workflow. To support and coordinate these efforts, the American College of Cardiology (ACC), the American Heart Association (AHA), the Healthcare Information and Management Systems Society (HIMSS), and the Radiological Society of North America (RSNA) have joined together to sponsor and launch the IHE Quality domain. Its mission is to address the infrastructure necessary to share information relevant to quality improvement in electronic patient care and health care records.

Priority: H : Essential Now, M : Essential Future, L : Nice to Have

Roadmap

Topic	Pri	Standards/Prerequesites	Coord	Strategy	Year
Peer Review Peer review and feedback		ACR RadPeer program AMA/ABMS program using performance measures for peer review of physician hospital groups
Decision support for ordering and procedure approvals		Massachusetts program based on ACR appropriateness criteria (consult with Dr. Keith Dreyer/MGH) Generate justification data when needed (through use of QED?) AQA principles for developing measures of appropriateness ACC/AHA Appropriateness Criteria, decision support tools
Retrospective review of outcomes based on utilization of evolving technologies		NOPR (PET registry) ACRIN/CMS/Brown Univ.
Radiation dose Appropriate aggregation of dose information Minimization of dose to target patient population
Real-time documentation of continuing education and certification (point-of-care CME)		ACCME standards for award of physician CME ABMS MOC requirements Medbiquitous/SCORM
Patient assessment to prevent adverse events
Adverse event reporting		Expected AHIC/ONC/HITSP Use Case on Adverse Events Joint commission requirements (per state) CDC has voluntary and mandatory reporting for some diseases Care coordination efforts across disciplines - NQF, CMS, Joint Commission Adverse Event Reporting Structural measures
Measure Reporting Institutional (process) Physician (performance) Core Measure Reporting (AHA?/JCAHO?)		AHIC/ONC/HITSP Use Case on Quality (including patient identity management) Measures developers (eg, AMA/PCPI, NCQA, ACC/AHA, JCAHO), endorsers, testers and implementers (eg, NQF, AQA) Measuring health delivery disparities across demographic segments (eg, race, gender, socioeconomic status) - AHA Health Research and Educational Trust, HRSA Care coordination efforts across disciplines - NQF, CMS Structural measures State/provincial/regional quality measures
Data registries Procedure-specific datasets (eg, ACC Carotid Artery Stent Registry) Intermediary point to aggregate date to share with CMS, other destination agencies Gathering quality data (peer review, patient safety, protocols in place and physician use of protocols) from various care settings		Disease management registries: STS, ACC NCDR, Tumor Registry, Trauma Registry, HDC Registry (HRSA) Immunization registries National Practitioner Database
Standardized reporting: develop standard formats for reports (eg, Echo, Cath Lab, Nuc Med) to ensure report has elements needed to collect quality data
Consumer aspects of quality reporting PHR as record of repeat procedures Consumer view of provider quality information Patient self management Home health monitoring Informed patient consent		NQF Consumer Council AARP OASIS Data for Home Care (CMS) CMS Hospital Compare and Nursing Home Compare
Harmonization with other initiatives NCVHS hearings in July