ONC Provides Vision for HIT-enabled Quality Improvement

The Office of the National Coordinator for Health Information Technology has released its vision for health IT-enabled quality improvements over the next 10 years.


The Office of the National Coordinator for Health Information Technology has released its vision for health IT-enabled quality improvements over the next 10 years.

“Leveraging health IT adoption and improving the exchange of health information through the use of health IT will be integral to supporting the essential building blocks of a quality improvement (QI) ecosystem,” states the ONC document. “This paper will illustrate ONC’s ten-year vision for advancing health IT capabilities in a manner that will combine, at a minimum, both clinical decision support (CDS) and clinical quality measurement (CQM) to enable robust and continuous quality improvement.”

Currently, ONC is in the process of developing a 10-year interoperability roadmap that is due to be released for public comment in January 2015. According to the just-released QI vision document, the nationwide interoperability roadmap will be interdependent with the quality initiative.

ONC’s vision is to create “an electronically enabled QI ecosystem that promotes better health and care, improved communication and transparency, rapid translation of knowledge for all stakeholders and reduction in the burden of data collection and reporting for providers.” According to the agency, health IT will “provide the necessary tools to achieve this vision through an interoperable infrastructure and supportive building blocks.”

Among the critical building blocks of ONC’s QI vision is capturing health and care data in a “structured” way that results in “accurate, reliable, clinically meaningful measurement across systems and settings of care.” As the document states, using data elements consistently and reliably will allow for “information to be collected once and reused for multiple purposes, including outcomes measurement, practice level improvements, surveillance, population health, research and decision support.” And, through real-time CDS interventions providers and individuals “can get the right information at the right time to improve decision making, leading to better quality and outcomes of health and health care.”

In its plan, ONC said will work with other federal agencies to develop interoperable CDS interventions and companion CQMs using new interoperable QI standards and make these resources available to the public. Using the Standards and Interoperability (S&I) Framework, Clinical Quality Framework (CQF) Initiative ONC and CMS, in partnership with Health Level 7, will harmonize and contribute to the development of standards for expressing and sharing CDS interventions and CQMs, ensuring these two sides of the QI coin are tightly coupled.”

Writing in a Nov. 13 ONC blog, Deputy National Coordinator Jacob Reider, M.D., commented that “while CDS and CQM have the same goals, (perfect care delivery—the highest quality care for all) their methods, technical tools, and standards have heretofore been disconnected from each other.” According to Reider, “we need to change the conversation from ‘CDS’ or ‘CQM’ and start talking as one community with an aligned focus of quality improvement.”

The ONC QI vision paper is available here.  

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