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NQF Updates Quality Data Model and Companion Style Guide


ETTING patient quality data into EHR systems in a measurable, apples-to-apples

comparable form is a tall order. The National Quality Forum (NQF) tackled that task with an update to its Quality Data Model (QDM) and an accompanying style guide for stakeholders who develop quality measures.

What Can Be Accomplished? The measurement tools will

eventually help providers, payers, and even individuals to make sense of their health data. The hope, said Shannon Sims, M.D., clinical informatics director at Rush University Medical Center, is that the Quality Data Model will help people who create those tools to identify and categorize patient data better than is done now through insurance claims CPT codes and patient chart reviews. “In order to accomplish this goal, we

really need a health IT infrastructure,” said Patrice Holtz, RN, nurse consultant for the CMS’s office of Clinical Quality and Standards. “The QDM is a common

language that can be used to represent the [quality of care] measure. The QDM is a grammar that defines and describes clinical concepts in a standardized format across all quality measures.”

Can We Tame the Wild West? Right now, Sims said, data elements

that a particular quality measure might require can be scattered throughout a provider's computer network, in various administrative and clinical applications from billing systems to lab information databases to EHRs. The data also can be housed in e-prescribing modules and external health information exchanges. In some cases, the data is unstructured and difficult to find. It all adds up to a “wild west” for quality-minded clinicians, Sims said. The QDM aims to help tame all that

data, by making it more accessible, in the electronic health record. The style book also can help designers of clinical quality measures understand what data is most feasible to acquire for a particular measure.


What’s the Point? Floyd Eisenberg, M.D., NQF senior

vice president of HIT, said the new QDM style guide lays out the data elements for quality measures development by sorting them into different categories. That will include what’s present as structured data in ONC-certified EHR systems; data elements written in to proposed 2014 EHR certification criteria; and those that are not part of certification criteria but which are feasible for doctors to collect during the course of care with small workflow changes. Also under consideration are new definitions of patient care procedures— physical acts like administering medications or observing the patient vs. interventions such as education. NQF is considering as well how to categorize participants in a patient’s care beyond the main doctor, such as assisting physicians or other patient caregivers, in a standard fashion.

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