Difference between revisions of "Quality Measure Execution-Early Hearing"

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The Quality Measure Execution-Early Hearing (QME-EH) profile describes the content needed to communicate patient-level data to electronically monitor the performance of early hearing detection and intervention (EHDI) initiatives for newborns.
 
The Quality Measure Execution-Early Hearing (QME-EH) profile describes the content needed to communicate patient-level data to electronically monitor the performance of early hearing detection and intervention (EHDI) initiatives for newborns.
  
 +
Part of the [[Early Hearing Detection and Intervention - Family of Profiles]]
  
 
__TOC__
 
__TOC__
  
 
==Summary==
 
==Summary==
−
The Newborn Hearing Screening measure (EHDI 1a) developed by the Centers for Disease Control and Prevention (CDC) and endorsed by the US National Quality Forum (NQF), has been selected as the sample measure for the Trial Implementation of this QME-EH profile. The EHDI- 1a measure provides patient-level information to track performance against the goal to provide hearing screening for all newborns prior to discharge from a birthing facility. Where specific US measure content is specified in this profile, realm-specific options and definitions have been used.
+
The Newborn Hearing Screening measure is a process measure conducted as a part of the U.S. Centers for Disease Control and Prevention (CDC) Early Hearing Detection and Intervention (EHDI) public health program. It measures the proportion of newborns who receive hearing screening prior to discharge at birth.
  
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The Quality Measure Execution-Early Hearing (QME-EH) content profile demonstrates the use of the HL7 Quality Reporting Document Architecture (QRDA) standard to implement the patient-level quality measure report (QRDA level I) for measures specific to newborn hearing screening. QRDA establishes the general implementation guidelines for using the HL7 Clinical Document Architecture Standard (CDA R2) to create different types of quality measure reports. QME-EH constrains QRDA for measures defined for the newborn hearing screening conducted as a part of the Early Hearing Detection and Intervention (EHDI) public health program.  
+
The Quality Measure Execution-Early Hearing (QME-EH) Content Profile outlines steps to create and consume standard electronic patient-level and aggregate-level quality reports for the Newborn Hearing Screening (CMS31v4) electronic clinical quality measure (eCQM). QME-EH provides methods for reusing data from a standard summary of care document, generated by an EHR to create a patient-level quality report. Additionally, it specifies how to create an aggregate-level quality report for the Newborn Hearing Screening quality measure using multiple patient-level quality reports.
 +
 
 +
This profile specifies information exchange methods which permit greater data transparency and consistency for the quality measurement process and which reduce the burden of compliance with quality measurement programs.
 +
 
 +
This profile does not specify how to determine if the set of documents (clinical summary documents or patient-level quality reports) supplied for processing is the correct and complete set of documents to be processed for the measure. Actors creating quality reports need to determine if a document that is supplied in the run meets the measure definition’s criteria for the initial population of the measure before processing the rest of the data. Data in documents which meet the initial population (IP) criteria should be included in the quality report. Refer to QRPH TF-3: X.6.3 for considerations regarding the use of a mechanisms defined within the IHE QRPH Newborn Admission Notification Information (NANI) Profile to confirm if the run of documents processed for the quality measure is complete.
  
 
==Benefits==
 
==Benefits==
−
 
+
*Ensures digital newborn hearing screening quality measure data are captured and communicated, supporting consistent quality measure computation
−
*Ensure that digital newborn hearing screening quality measure data captured and communicated consistently in order to support consistent quality measure computation
+
*Standardizes quality measurement for newborn care in birthing facilities
−
*Standardize quality measurement for care of newborns born in a birthing facility
+
*Provides interoperability between clinical EHRs and Public Health EHDI Information Systems (EHDI-IS) for increased efficiency and data quality
−
*Provide interoperability between clinical EHRs and Public Health EHDI Information Systems (EHDI-IS) for increased efficiency and better data quality
+
*Reduces reporting burden for EHRs by allowing quality measure data to be consumed out of standard clinical summaries
  
 
==Details==
 
==Details==
−
 
+
The Quality Measure Execution-Early Hearing (QME-EH) content profile specifies how to use the HL7 Quality Reporting Document Architecture (QRDA) standard to implement a patient-level quality measure report for newborn hearing screening.
−
The Quality Measure Execution-Early Hearing (QME-EH) content profile specifies how to use the HL7 Quality Reporting Document Architecture (QRDA) standard to implement a patient-level quality measure report for newborn hearing screening.  
 
  
 
QRDA is a specialized implementation guide (IG) for the HL7 Clinical Document Architecture standard (CDA R2). It establishes general guidelines for creating three types of CDA documents for sharing different types of quality measure reports.
 
QRDA is a specialized implementation guide (IG) for the HL7 Clinical Document Architecture standard (CDA R2). It establishes general guidelines for creating three types of CDA documents for sharing different types of quality measure reports.
  
−
The QME-EH profile shows implementers how to use a supplied measure definition for newborn hearing screening, and the measure definition’s associated data set and data processing logic, to create and consume a CDA-based patient-level quality measure report. This includes:
+
The QME-EH profile shows implementers how to use a supplied measure definition for newborn hearing screening, and the measure definition’s associated data set and data processing logic, to create and consume a CDA-based patient-level or aggregate-level quality measure report.
−
*Measure Section: Each Measure Section in the report declares which measure(s) the data enclosed within the section is intended to support. Each measure section further includes:
 
−
*Reporting Parameters Section: Within each Measure Section, the patient-level QRDA document provides information about the reporting time interval applicable for creating or consuming the data associated with that measure or set of measures. The reporting time interval is jurisdictionally defined. This may contain other information that provides context for the patient data being reported.
 
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*Patient Data Section: Within each Measure Section, the patient-level QRDA document encodes discrete data needed to process the data and execute the assessment defined for the quality measure or set of measures.
 
  
 
==Systems Affected==
 
==Systems Affected==
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''<List (in user terms) the types of systems they might expect to have implemented actors from this profile, e.g. RIS, PACS, HIS, CAD Workstation, etc. and for each, how it would participate.>''
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Figure X.1-1 shows the actors directly involved in the QME-EH Profile and the direction that the content is exchanged. The technical actor initiating information sharing has options for creating a Summary of Care Document, a Patient-Level Quality Report, or an Aggregate-Level Quality Report. The technical actor consuming the information similarly has the same options. This flexible design permits the burden of reporting to be shared across different systems with varying levels of quality measure computation functionality.
  
−
* ''PACS systems may store, manage, and/or display Evidence Documents.''
+
<center>[[Image:Figure_X.1-1-Actor_Diagram_QME-EH.jpg]]</center>
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* ''Display systems may query, retrieve and display Evidence Documents.''
 
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* ''Reporting workstations may retrieve, process and include details from Evidence Documents in reports
 
  
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'''Actors & Transactions:'''
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Note: The Actor Diagram for this profile is modular in nature. Options are used to indicate the grouping requirements/capabilities of a system participating in the information exchange supporting creation of the quality measure reports. The actor options for a participating system are determined by the role the system intends to play in a particular use case for this profile (see Section X.2 and X.3). Use Cases in Section X.3 include customized diagrams which specify the actor options needed to support the various use cases. Section X.4.1 contains additional information about the concepts behind the modular grouping options in this profile.
  
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''<Insert an actor-transaction diagram, and or list of Content Definitions>''
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A product implementation using this profile must group actors from this profile with actors from a workflow or transport profile to be functional. The grouping of the content module described in this profile to specific actors is described in more detail in the “Required Actor Groupings” section of the [http://ihe.net/Technical_Framework/upload/IHE_QRPH_Suppl_QME-EH.pdf IHE QRPH Supplement QME-EH].
  
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==Specification==
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Table X.1-1 lists the content module(s) defined in the QME-EH Profile. To claim support with this profile, an actor shall support all required content modules (labeled “R”) and may support optional content modules (labeled “O”).
  
−
'''Profile Status:''' [[Comments| Final Text]] 
 
−
''<Replace "Final Text" with "Trial Implementation" or "Public Comment" as appropriate.>''
 
  
−
'''Documents:'''
+
{| class="wikitable"
 +
|+Table X.1-1 – Actors and Content Modules
 +
|-
 +
! scope="col"| Actors
 +
! scope="col"| Content Modules (See Note 1)
 +
! scope="col"| Optionality
 +
! scope="col"| Reference
 +
|-
 +
! scope="row"| Report Assembler
 +
| EHDI Measure Definition (eCQM EDHI)
 +
| R
 +
| QRPH TF-1:Appendix C
 +
|-
 +
! scope="row"| Content Consumer (See Note 1)
 +
| Summary of Care Document (SoCD)
 +
| O
 +
| A C-CDA Clinical summary. For the US Realm this is a CCD or Discharge Summary which includes information needed to populate the data elements defined for a PLQR. (See QRPH TF-4: Appendix D.1.1)
 +
|-
 +
! scope="row"| Content Consumer (See Note 1)
 +
| Aggregate-Level Quality Report (ALQR)
 +
| O
 +
| For US Realm, see QRPH TF-4:R1.3.1.1.D2
 +
|-
 +
! scope="row"| Content Consumer (See Note 1)
 +
| Patient-Level Quality Report
 +
| O
 +
| For US Realm, see QRPH TF-4:R1.3.1.1.D1
 +
|-
 +
! scope="row"| Content Creator (See Note 1)
 +
| Summary of Care Document (SoCD)
 +
| O
 +
| Any C-CDA clinical summary such as a CCD or Discharge Summary which includes information needed to populate the data elements defined for a PLQR. For US Realm, see QRPH TF-4:Appendix D.1.1
 +
|-
 +
! scope="row"| Content Creator (See Note 1)
 +
| Aggregate-Level Quality Report (ALQR)
 +
| O
 +
| For US Realm, see QRPH TF-4:R1.3.1.1.D2
 +
|-
 +
! scope="row"| Content Creator (See Note 1)
 +
| Patient-Level Quality Report (PLQR)
 +
| O
 +
| For US Realm, see QRPH TF-4:R1.3.1.1.D1
 +
|}
  
−
''<Provide direct links to the specific volumes or supplements, and list the volume sections relevant to this profile.  This is a simple inventory of official normative and informative text.  If you would like to provide a reading guide or walkthrough of what is in each of the different sections for implementers or users, do that in the Profile FAQ or the Profile Implementation Page linked below.  If the profile uses transactions from multiple Tech. Frameworks, repeat the structure below.>''
 
  
−
[http://www.ihe.net/Technical_Framework/index.cfm#radiology IHE Radiology Technical Framework:]
+
Options that may be selected for each actor in this profile, if any, are listed in Table X.2-1. Dependencies between options when applicable are specified in notes.
−
:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8.pdf Vol. 1] - Section 5 (SWF Profile)
 
−
:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-2.pdf Vol. 2] - Sections 4.8 to 4.10, 4.14 to 4.19, and 4.23
 
−
:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-3.pdf Vol. 3] - Appendix E
 
  
−
'''Underlying Standards:'''
+
{| class="wikitable"
 +
|+Table X.2.1 – Actors and Options
 +
|-
 +
! scope="col"| Actor
 +
! scope="col"| Option Name
 +
! scope="col"| Reference
 +
|-
 +
! scope="row"| Content Creator (See Note 1)
 +
| Aggregate-Level Quality Report (ALQR) Option
 +
| QRPH TF-1:X.2.1
 +
|-
 +
! scope="row"| Content Creator (See Note 1)
 +
| Patient-Level Quality Report (PLQR) Option
 +
| QRPH TF-1:X.2.2
 +
|-
 +
! scope="row"| Content Creator (See Note 1)
 +
| Summary of Care Document (SoCD) Option
 +
| QRPH TF-1:X.2.3
 +
|-
 +
! scope="row"| Content Consumer (See Note 2)
 +
| Aggregate-Level Quality Report (ALQR) Option
 +
| QRPH TF-1:X.2.1
 +
|-
 +
! scope="row"| Content Consumer (See Note 2)
 +
| Patient-Level Quality Report (PLQR) Option
 +
| QRPH TF-1:X.2.2
 +
|-
 +
! scope="row"| Content Consumer (See Note 2)
 +
| Summary of Care Document (SoCD) Option (See Note 3)
 +
| QRPH TF-1:X.2.3
 +
|-
 +
! scope="row"| Report Assembler (See Note 4)
 +
| Assemble Patient-Level Quality Report from Summary of Care Document (SoCD) to PLQR) Option
 +
| QRPH TF-1:X.2.4
 +
|-
 +
! scope="row"| Report Assembler (See Note 4)
 +
| Assemble Aggregate-Level Quality Report from Patient-Level Quality Report (PLQR to ALQR) Option
 +
| QRPH TF-1:X.2.5
 +
|}
  
−
''<list all the standards on which the profile is based; if possible with links to sources>''
+
==Specification==
−
:* [http://dicom.nema.org DICOM]
 
−
:* [http://www.hl7.org HL7]
 
−
:* ...
 
  
−
==See Also==
+
'''Profile Status:'''
 +
Trial Implementation 
  
−
''<The following sections can be left out if there is nothing to point to. This is just to show where such information can go.>''
+
:* [http://ihe.net/Technical_Framework/upload/IHE_QRPH_Suppl_QME-EH.pdf IHE QRPH Supplement QME-EH]
  
  
−
'''Related Profiles'''
+
'''Underlying Standards:'''
  
−
''<List profiles this one depends on, profiles that depend on this one, profiles that are synergistic with this one. Start with the name of the other profile as a link and then explain the relationship.>''
+
*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=7 HL7 Clinical Document Architecture (CDA® Release 2)]
 +
* HL7 QRDA R3 Jun 2105
 +
* HL7 QDM-Based HQMF R1 Feb 2014
 +
*[http://loinc.org/ Logical Observation Identifiers Names and Codes (LOINC®)]
 +
*[http://www.ihtsdo.org/snomed-ct/ Systematized Nomenclature Of Medicine Clinical Terms (SNOMED-CT)]
  
−
* ''[[Reporting Workflow]] [RWF] may use Evidence Documents as inputs to the reporting process.''
 
−
* ''[[Simple Image & Numeric Reports]] [SINR] may include data copied from Evidence Documents.''
 
−
* ''[[Cross-enterprise Document Sharing for Imaging]] [XDS-I] can be used to share Evidence Documents between sites over a network.''
 
−
* ''[[Portable Data for Imaging]] [PDI] can store Evidence Documents on media such as CDs.''
 
−
* ''[[Import Reconciliation Workflow]] [IRWF] can fix patient ids, etc. of Evidence Documents when importing.''
 
  
  
−
'''Consumer Information'''
+
This page is based on the [[Profile Overview Template]]
−
 
 
−
The [[Profile FAQ Template]] answers typical questions about what the Profile does.  ''<Replace the link with a link to the actual FAQ page for the Profile>''
 
  
−
The [[Profile Purchasing Template]] describes considerations when purchasing equipment to deploy this Profile.  ''<Replace the link with a link to the actual Purchasing page for the Profile>''
+
[[Category:Profiles]]
−
 
+
[[Category:QRPH Profile]]
−
'''Implementer Information'''
+
[[Category:CDA]]
−
 
+
[[Category:DocShare]]
−
The [[Profile Implementation Template]] provides additional information about implementing this Profile in software.  ''<Replace the link with a link to the actual Implementation page for the Profile>''
+
[[Category:Hearing]]
−
 
 
−
'''Reference Articles'''
 
−
 
 
−
''<List References (good and bad) (with link if possible) to Journal Articles that mention IHE's work (and hopefully include some analysis).  Go ahead, Google: IHE <Profile Name> abstract  or Google: IHE <Profile Name> and under the "more" select "Scholar".  You might be surprised. >''
 
−
 
 
−
 
 
−
 
 
−
This page is based on the [[Profile Overview Template]]
 

Latest revision as of 18:29, 4 November 2019

The Quality Measure Execution-Early Hearing (QME-EH) profile describes the content needed to communicate patient-level data to electronically monitor the performance of early hearing detection and intervention (EHDI) initiatives for newborns.

Part of the Early Hearing Detection and Intervention - Family of Profiles

Summary

The Newborn Hearing Screening measure is a process measure conducted as a part of the U.S. Centers for Disease Control and Prevention (CDC) Early Hearing Detection and Intervention (EHDI) public health program. It measures the proportion of newborns who receive hearing screening prior to discharge at birth.

The Quality Measure Execution-Early Hearing (QME-EH) Content Profile outlines steps to create and consume standard electronic patient-level and aggregate-level quality reports for the Newborn Hearing Screening (CMS31v4) electronic clinical quality measure (eCQM). QME-EH provides methods for reusing data from a standard summary of care document, generated by an EHR to create a patient-level quality report. Additionally, it specifies how to create an aggregate-level quality report for the Newborn Hearing Screening quality measure using multiple patient-level quality reports.

This profile specifies information exchange methods which permit greater data transparency and consistency for the quality measurement process and which reduce the burden of compliance with quality measurement programs.

This profile does not specify how to determine if the set of documents (clinical summary documents or patient-level quality reports) supplied for processing is the correct and complete set of documents to be processed for the measure. Actors creating quality reports need to determine if a document that is supplied in the run meets the measure definition’s criteria for the initial population of the measure before processing the rest of the data. Data in documents which meet the initial population (IP) criteria should be included in the quality report. Refer to QRPH TF-3: X.6.3 for considerations regarding the use of a mechanisms defined within the IHE QRPH Newborn Admission Notification Information (NANI) Profile to confirm if the run of documents processed for the quality measure is complete.

Benefits

  • Ensures digital newborn hearing screening quality measure data are captured and communicated, supporting consistent quality measure computation
  • Standardizes quality measurement for newborn care in birthing facilities
  • Provides interoperability between clinical EHRs and Public Health EHDI Information Systems (EHDI-IS) for increased efficiency and data quality
  • Reduces reporting burden for EHRs by allowing quality measure data to be consumed out of standard clinical summaries

Details

The Quality Measure Execution-Early Hearing (QME-EH) content profile specifies how to use the HL7 Quality Reporting Document Architecture (QRDA) standard to implement a patient-level quality measure report for newborn hearing screening.

QRDA is a specialized implementation guide (IG) for the HL7 Clinical Document Architecture standard (CDA R2). It establishes general guidelines for creating three types of CDA documents for sharing different types of quality measure reports.

The QME-EH profile shows implementers how to use a supplied measure definition for newborn hearing screening, and the measure definition’s associated data set and data processing logic, to create and consume a CDA-based patient-level or aggregate-level quality measure report.

Systems Affected

Figure X.1-1 shows the actors directly involved in the QME-EH Profile and the direction that the content is exchanged. The technical actor initiating information sharing has options for creating a Summary of Care Document, a Patient-Level Quality Report, or an Aggregate-Level Quality Report. The technical actor consuming the information similarly has the same options. This flexible design permits the burden of reporting to be shared across different systems with varying levels of quality measure computation functionality.

Figure X.1-1-Actor Diagram QME-EH.jpg

Note: The Actor Diagram for this profile is modular in nature. Options are used to indicate the grouping requirements/capabilities of a system participating in the information exchange supporting creation of the quality measure reports. The actor options for a participating system are determined by the role the system intends to play in a particular use case for this profile (see Section X.2 and X.3). Use Cases in Section X.3 include customized diagrams which specify the actor options needed to support the various use cases. Section X.4.1 contains additional information about the concepts behind the modular grouping options in this profile.

A product implementation using this profile must group actors from this profile with actors from a workflow or transport profile to be functional. The grouping of the content module described in this profile to specific actors is described in more detail in the “Required Actor Groupings” section of the IHE QRPH Supplement QME-EH.

Table X.1-1 lists the content module(s) defined in the QME-EH Profile. To claim support with this profile, an actor shall support all required content modules (labeled “R”) and may support optional content modules (labeled “O”).


Table X.1-1 – Actors and Content Modules
Actors Content Modules (See Note 1) Optionality Reference
Report Assembler EHDI Measure Definition (eCQM EDHI) R QRPH TF-1:Appendix C
Content Consumer (See Note 1) Summary of Care Document (SoCD) O A C-CDA Clinical summary. For the US Realm this is a CCD or Discharge Summary which includes information needed to populate the data elements defined for a PLQR. (See QRPH TF-4: Appendix D.1.1)
Content Consumer (See Note 1) Aggregate-Level Quality Report (ALQR) O For US Realm, see QRPH TF-4:R1.3.1.1.D2
Content Consumer (See Note 1) Patient-Level Quality Report O For US Realm, see QRPH TF-4:R1.3.1.1.D1
Content Creator (See Note 1) Summary of Care Document (SoCD) O Any C-CDA clinical summary such as a CCD or Discharge Summary which includes information needed to populate the data elements defined for a PLQR. For US Realm, see QRPH TF-4:Appendix D.1.1
Content Creator (See Note 1) Aggregate-Level Quality Report (ALQR) O For US Realm, see QRPH TF-4:R1.3.1.1.D2
Content Creator (See Note 1) Patient-Level Quality Report (PLQR) O For US Realm, see QRPH TF-4:R1.3.1.1.D1


Options that may be selected for each actor in this profile, if any, are listed in Table X.2-1. Dependencies between options when applicable are specified in notes.

Table X.2.1 – Actors and Options
Actor Option Name Reference
Content Creator (See Note 1) Aggregate-Level Quality Report (ALQR) Option QRPH TF-1:X.2.1
Content Creator (See Note 1) Patient-Level Quality Report (PLQR) Option QRPH TF-1:X.2.2
Content Creator (See Note 1) Summary of Care Document (SoCD) Option QRPH TF-1:X.2.3
Content Consumer (See Note 2) Aggregate-Level Quality Report (ALQR) Option QRPH TF-1:X.2.1
Content Consumer (See Note 2) Patient-Level Quality Report (PLQR) Option QRPH TF-1:X.2.2
Content Consumer (See Note 2) Summary of Care Document (SoCD) Option (See Note 3) QRPH TF-1:X.2.3
Report Assembler (See Note 4) Assemble Patient-Level Quality Report from Summary of Care Document (SoCD) to PLQR) Option QRPH TF-1:X.2.4
Report Assembler (See Note 4) Assemble Aggregate-Level Quality Report from Patient-Level Quality Report (PLQR to ALQR) Option QRPH TF-1:X.2.5

Specification

Profile Status: Trial Implementation


Underlying Standards:


This page is based on the Profile Overview Template

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