Creating a learning healthcare system will require more closely aligning the tools, teams and goals of clinical decision support (CDS) and clinical quality measures (CQM) efforts, according to a blog post at Health IT Buzz.
The two have long taken parallel paths, but both must be brought together as one community focused on quality improvement, write Jacob Reider, Deputy National Coordinator, and Alicia Morton, director of the Health IT Certification Program.
The Office of the National Coordinator has released a paper outlining its 10-year vision for harnessing health IT for quality improvement, which it describes as interdependent with its efforts to achieve interoperability.
The quality improvement vision includes:
- Rapid translation of research, evidence, or best practices into electronically actionable guidelines that enable decision support, quality measurement and reporting
- Capturing data once and reusing it many times
- Valid, reliable and accurate patient outcome measures
- Robust and real-time analytical tools for routine, practice-level and ad-hoc measurement.
- Interoperable and easy- to-use tools for collecting and using existing data in multiple ways.
There is also a three-year vision centered on developing universally accepted performance indicators such as preventable hospital readmissions and reduction of healthcare-associated conditions. A key component is the capture of highly structured, shareable data that can be used in multiple ways. ONC will work with guideline developers to transform the knowledge into computable and executable formats, and define a structure for use in certified health IT products.
The six-year vision focuses on "big data." Standardized data from the patient level will be optimized for interoperable sharing and aggregation. Through its open-data initiative, the Department of Health and Human Services will make more rich data sources available for research and innovation. Multi-directional feedback loops will accelerate the defining and updating of evidence-based clinical best practices.
The 10-year vision looks to have, by 2014, full interoperability of health IT tools and have the quality improvement ecosystem stakeholders work seamlessly and interact daily. Healthcare will transform into preventive, predictive and precise models. Care will be highly personalized and there will be real-time data feeds, communication and information exchange among providers, patients, payers, public health departments and community social services agencies, according to the vision.
A draft of the ONC's 10-year interoperability road map outlines goals for governance and certification standards and calls for "unprecedented collaboration" in ensuring that technology can seamlessly support the health of patients on a day-to-day basis.