The federal government is creating a new database, or system of records, to collect quality data from hospices. Collection of the data is required under the Affordable Care Act.
The database is named the Hospice Item Set System, known as HIS. According to a published notice, HIS is a standardized, patient-level data collection vehicle consisting of data elements confirming that the appropriate assessments were made and inquiries or concerns were addressed for each patient at the time of admission for the following domains of care: 1) Pain, 2) respiratory status, 3) medications, 4) patient preferences, and 5) beliefs and values.
While the Centers for Medicare and Medicaid Services will administer the database, information also will be collected on hospice patients who are not Medicare beneficiaries. Hospices will start using the HIS for all patients on July 1, 2014. The quality measures being collected, all related to hospice and palliative care are:
* Pain Screening (NQF #1634),
* Pain Assessment (NQF #1637),
* Dyspnea Screening (NQF #1639),
* Dyspnea Treatment (NQF #1638),
* Patients Treated with an Opioid who are Given a Bowel Regimen (NQF #1617),
* Treatment Preferences (NQF #1641), and
* Beliefs/Values Addressed (modified version of the NQF #1647 measure).
Hospices will submit two HIS records--admission and discharge--for each admitted patient. The HIS-Admission contains both administrative items for patient identification and clinical items for calculating the seven quality measures, according to the notice from CMS. The HIS-Discharge is a limited set of administrative items also used for patient identification, as well as discharge information, which will be used primarily to determine patient exclusions for some of the seven quality measures.
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