NQF Releases Reports to Promote CDS and HIT Use

Washington, DC (January 6, 2011) - Today, the National Quality Forum (NQF) released two new reports-Driving Quality: A Model to Measure Electronic Health IT Use and Driving Quality and Performance Measurement: A Foundation for Clinical Decision Support. In direct support of the Health Information Technology for Economic and Clinical Health Act (HITECH) in the American Recovery and Reinvestment Act (ARRA), NQF's work will promote effective use of health IT tools, ensure a stronger health IT infrastructure, and help improve America's healthcare system.

"These reports provide a tremendous foundation for future work in clinical decision support and for understanding the impact of health IT tools on care delivery," said Janet Corrigan, PhD, MBA, NQF president and CEO. "It also lays the groundwork for what kind of standards and certification criteria should be considered and put into practice for health IT use measures."

Identifying and developing health IT use measures and tracking performance on these measures requires an understanding of a system's features and functions and when and how they are used. The Driving Quality-A Health IT Assessment Framework for Measurement report, based on the work of NQF's Health Information Technology Utilization Expert Panel, developed the "Health IT Use Assessment Framework." This framework provides a unique approach to measuring the use of health IT tools and how that use improves care processes, quality, and safety. Additionally, as health IT use measures are developed, the framework will provide clear guidelines for the information needed to construct these measures.

The Expert Panel's work expands on the Quality Data Set (QDS). The QDS is "a model of information" that clearly describes clinical concepts used in quality measurement and clinical care so providers, researchers, measure developers, and others monitoring clinical performance and outcomes can consistently communicate necessary information. The QDS model also describes information in a manner that allows EHR and other health IT vendors to interpret the data and clearly locate the data required.

"This report establishes an essential foundation on which measures of health IT utilization can be developed and used to assess the adoption and effective use of these clinical information systems," said Blackford Middleton, MD, MPH, MSc, chair of the Health IT Utilization Expert Panel. "This is critical to determine whether both clinical quality and policy goals are being met for meaningful use under the HITECH Act and helps establish a ‘dose-response' curve for health IT when used in practice."

In addition, CDS tools are an essential health IT system capability and will play an important role in improving healthcare quality, safety, and effectiveness. As such, a common categorization, or "taxonomy," is necessary to enable health IT system developers, system implementers, and the quality improvement community to develop tools, content, and policies compatible with CDS features and functions. NQF convened the Clinical Decision Support Expert Panel to develop this CDS taxonomy. The Driving Quality and Performance Measurement: A Foundation for Clinical Decision Support report provides a foundation for the description of an electronic infrastructure, bridging quality measurement and health IT.

"Improving both documentation and performance on priority quality measures is fundamental to achieving and demonstrating the meaningful use of health IT," said Michael Krall, MD, MS, chair of the CDS Expert Panel that drafted the report. "The NQF CDS Taxonomy makes a major contribution to this by providing a means to better understand and articulate the role of CDS in improving performance and patient outcomes. . This will result in enhanced design and implementation of CDS within EHRs and help to substantially increase HIT effectiveness."

"This rich body of work will enable patients and providers to better access and apply evidence-based information in decisionmaking about health, wellness, and care delivery and assess the full impact of EHRs and other health IT tools on patient care and quality improvement overall," added Floyd Eisenberg, MD, MPH, NQF's senior vice president for HIT.

The work of the Health IT Utilization Expert Panel and the CDS Expert Panel advances the focus from adopting health IT to appropriately and effectively using it. The Health IT Use Assessment Framework signals to the healthcare community that implementing a health IT system is a commitment to effective health IT use. Monitoring, measuring, and reporting this use is also necessary to achieve these goals. The CDS Taxonomy will enable quality measure developers, clinical system implementers, and vendors to more effectively develop, share, and evaluate the impact of applying and aligning CDS and quality measurement. Together, they will help improve the quality, safety, and effectiveness of healthcare in America.

NQF is a unique, multistakeholder, nonprofit organization dedicated to improving the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs.

The National Quality Forum (NQF) operates under a three-part mission to improve the quality of American healthcare by: 

  • Building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;  
  • Endorsing national consensus standards for measuring and publicly reporting on performance; and 
  • Promoting the attainment of national goals through education and outreach programs.