Brief Profile Proposal for 2014/15presented to the

Quality, Research & Public Health (QRPH) Planning Committee

Lisa R. Nelson, Lantana Consulting Group (LCG)Public Health Informatics Institute (PHII)

Centers for Disease Control and PreventionOffice of Noncommunicable Diseases, Injury and Evironmental Health

National Center on Birth Defects and Developmental Disabilities (NCBDDD)(CDC/ONDIEH/NCBDDD)

October 17, 2014

WORLD

The Market

World

www.ecology.com

http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_02.pdf

US National Vital Statistics Report

The ProblemAssure hearing screening for all newborns

Innovation is needed to improve the process: more efficient, more effective, achieve better outcomes through continuous process improvement

Quality Measure standards are evolving

Innovation is needed to protect prior investment, harness current/relevant technical standards-based capabilities

Burden of surveillance/quality measurement is escalating

Innovation is needed to reduce the burden

The burden of data collection is not aligned withthe benefit incenting collection of the needed data

Innovation is needed to shift/align the data collection model

Process

Value PropositionThe update of the QME-EH profile will:

establish a method for efficiently and effectively implementing electronic clinical quality measures (eCQM) for early hearing screening (EHDI-1a, NQF1354) which will shift the implementation model to reduce the burden of quality measure data collection and can be applied to benefit all eCQM implementations.

Faster adoption of electronic CQMs, reduced cycle time for innovation, faster payoff.

More data, less burden.

Better alignment between bearing the burden and reaping the benefit.

Process Improvement

Market Readiness

Legislated Use Cases

• EHDI-1a is one of 29 Clinical Quality Measures for Eligible Hospitals

Shifting focus to electronic CQM submission

• Meaningful Use Stage 3 will push electronic submission, eCQMs

• International interest in developing eCQM capability

Emerging “suppliers” positioned strategically to meet the demand for eCQM support with new “combined capabilities”

• Benefits from investment in “data element” capabilities

• Additional promotional efforts

• EHDI community and vendors

• eCQM in general

• Emerging international implementations Assessments Conferences

On-lineEducation

Existing IHE Profiles and RisksRisk of this proposal not being undertaken this cycle?

IHE OPPORTUNITY COSTS

Lost opportunity to establish SDO “positioning and differentiation”- IHE establishes standard methods for the application of standards- HL7 builds and maintains standards

Missed chance to show “catalytic conversion competency” within IHE- IHE meets emerging standards application needs- “JIT Applied Innovation”

Failure to capitalize on prior investment, leverage current assets- IHE Technical Framework creates economies of scale for standards

development- More meaningful uses for existing standards

Use Case

Current Use Case

Creation of the QRDA R1.0

- Category I document

Data collection/file creation burden on EMR System

Proposed Use Case

Creation of the QRDA R2.0 (with C-CDA R1.1 errata)

- Category I and Category III documents

Data collection burden eased, Utilize SDC (innovative application)

Shifted to a PHIS “self-serve” model

Suggest a role for Redaction Services Profile (out of scope)

Proposed Standards & Identified Systems

HL7• CDA R2, C-CDA R1.1 CCD, • QRDA R2 with errata for C-CDA R1.1,

Category I and Category III • QDM-based HQMF R1.1

NQF• QDM 4.1.1

IHE• Quality Measure Execution for Early

Hearing (QME-EH)• Structured Data Capture (SDC)

Vocabulary Standards• SNOMED CT• LOINC

Electronic Medical Record (EMR) System• Produce C-CDA R1.1 CCD

Public Health Information System (PHIS)• Consume CCD• Produce QRDA Cat I and Cat III • Consume QRDA Cat I and Cat III

Discussion

What level of effort do you foresee in developing this profile?- Moderate Effort

- Content Profile – - Primarily an update of standards- QRDA Document vs. CDA Document content modules- US and International solution simultaneously addressed (?)

- New Use Case work- New Actor-Transaction Diagram

- No new actors, no new transactions- Grouping of existing IHE Actors

- (Content Creator, Content Consumer grouped with other IHE Actors)

- New Sequence Diagram

Profile Editor:Lisa Nelson, Lantana Consulting GroupLisa.Nelson@LantanaGroup.com