The National Committee on Vital and Health Statistics, an advisory body to the Department of Health and Human Services, has made several recommendations to facilitate meaningful measurement of care quality using electronic health records.

A core purpose of the HITECH Act is to accelerate adoption and meaningful use of EHRs to measure and improve health care processes and outcomes, NCVHS noted in a recent letter to HHS Secretary Kathleen Sebelius. "In order to effectively produce comparative quality data, EHRs must be designed with quality reporting requirements in mind. For example, EHRs must be designed to capture relevant clinical data using standardized data definitions and standardized quality measure definitions. To receive HITECH incentive payments, providers will need to collect specific data to build quality of care reports."

The committee's recommendations include:

* HHS should develop a national quality and performance measurement strategy and establish an oversight structure to coordinate existing initiatives in the national strategy.

* HHS should fund creation of a library of specifications for quality and performance measures and their associated essential EHR data elements. These elements would be the building blocks for quality measures and risk adjustors.

* The Office of the National Coordinator should require as part of EHR system certification that vendors use relevant standard data element definitions from the quality and performance data specification library when producing data in compliance with the meaningful use criteria. EHRs should employ data exchange methods to support the computation of quality measures, whether computation is internal or external. To ensure patient trust, these exchange methods should be structured to protect data security, privacy and confidentiality. EHRs, as part of continued certification, also should have the capability of incorporating new standardized data elements in a timely manner as they are identified.

The complete letter is available at ncvhs.hhs.gov/091201lt.pdf.

--Joseph Goedert

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