Performance Measurement Data Element Structured for EHR Extraction

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Current work

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

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.

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