Significant efforts are underway to develop an end-to-end approach to quality reporting from EHRs, according to Health Level 7 International (HL7), which hosted a webinar on the topic earlier this week.
"Standards are a prerequisite to functionality. When it comes to quality reporting, if you can't measure it, you can't improve it. If you can't standardize it, you can't measure it," Bob Dolin, president and chief medical officer at Lantana Consulting Group, Past chair of vice chair of HL7 and co-chair of the HL7 Structured Documents Work Group, said during the online event.
A certified EHR should be able to import a quality measure and create a report, Dolin noted, adding that Stage 2 of Meaningful Use require a four-step process to aggregate quality reporting: capturing data, exporting data, calculating it and reporting it.
HL7 and others are working on standards to achieve this reporting, Dolin said. For instance, the eMeasure standard plays a role in both exporting and in calculating the quality report. The data capture standard comes not from HL7 but from the National Quality Forum Quality Data Model. The proposed rule on the Meaningful Sse standards requested comment on whether the Quality Reporting Document Architecture or the continuity of care document (CCD) would be adequate standards for export.
"CCD was cited in Stage 1. QRDA may be cited in Meaningful Use Stage 2," Dolin said.
Dolin also pointed out that simplifying the standards was a high priority for HL7. "It's important not just to create high quality standards but to make it as easy as possible for the EHR to spit out …the document."
He warned that the efforts to obtain quality reports can "fall short" if other issues aren't addressed, such as inconsistent and ambiguous data capture requirements for queries on tobacco use.
"If we ignore data capture, all of this downstream can be crappy data," he points out.
To learn more:
- read an announcement about the webinar
- learn more about Health Level 7 International
- here are the proposed rules for Stage 2 of Meaningful Use
- here's the proposed rule on the standards and certification of EHRs