iCentrix Corp. - Clinical Quality-Measures
iCentrix Corp.

MANAGE CLINICAL QUALITY-MEASURE PERFORMANCE GOALS


The Meaningful Use Clinical Quality Measures are becoming an increasingly important component of the performance requirements placed on healthcare providers today. Many programs already require the capability to meet specific quality targets and demonstrate continuous process improvement, and later stages will increase the focus on clinical quality.

The goal of producing better outcomes at a lower cost, necessitates a measurement and management focus, and payors today are requiring providers to demonstrate the capability to 1) measure and manage access and continuity of care, 2) measure and manage patient populations, 3) manage care of high risk patients, 4) track and coordinate care, 5) implement continuous quality improvement, and 6) share performance data across the enterprise and with partner agencies, CMS, NCQA, states, payors, public health agencies and other outside parties.

Managers in this dynamic environment need on-demand access to information, and the capability to leverage information to improve performance.

iCentrix has leveraged 11 years of experience developing data warehouses and business intelligence (BI) dashboards for healthcare providers, to create a meaningful use decision support engine - a set of advanced BI tools that provides managers with on-demand access to information and a complete suite of interactive tools to support trend analysis, population management and continuous quality improvement based on the Meaningful Use NQF Clinical Quality Measures.

Multiple Data Sources
The CQM BI Dashboard uses an underlying data warehouse that integrates data from multiple sources using a standard clinical data model that includes all of the data relationships needed to support clinical decision making and continuous quality improvement.

Dashboard Approach
Information is accessed using a self-service Dashboard that displays year-to-date trends for each of the clinical quality measures. As shown in the Percent Vaccinated YTD chart, managers can leverage these historical perspectives to spot trends throughout the reporting year, allowing them to manage to the numbers and achieve annual goals and higher outcomes. A forecasting tool allows managers and analysts to project end-of-year performance numbers based on performance-to-date. The dashboard information is up-to-date to the day, so managers can spot trends early. Information is provided specific to each stakeholder’s role, from senior executive, to department director, to individual doctor and care team member.

Drilldown Dimensions
Drilldown dimensions provide tools to rapidly spot trends in sub-populations, including cultural, geographic, and demographic characteristics, clinical considerations such as diagnosis or prescribed medicines, as well as organizational concepts such as management role and responsibilities, organization structure (such as Clinic, Site or Facility), and many others.

Drilldown dimensions allow managers and analysts to quickly spot pockets of poor quality and identify opportunities for rapid quality improvement.

For example:
To achieve childhood immunization targets, managers and analysts can examine cultural, geographic and demographic characteristics to identify techniques for improving communication with and access to parents and caregivers regarding scheduling and maintaining vaccination appointments.

Drilldown Measure Types
The clinical quality measures are designed to facilitate reporting and benchmarking of quality performance across providers. As such, they are derived measures that roll-up significant amounts of information into a single number that can be used for comparison. Reporting is per calendar year, and the measures are inherently backwards-looking in that they are designed to produce measurements of the prior year.

The figure shows the various elements that make up the clinical quality measures: numerators comprised of criteria met or resolved, and denominators comprised of number eligible or excluded. However, in order to support managing to the numbers to meet targets and support continuous quality improvement, managers and analysts will need additional measurements designed to spot trends, gain insight, and provide forward looking views.
For starters, they will need to track progress towards goals throughout the year. This requires year-to-date (YTD) measures that break the numbers down throughout the year and show the track they are on as they approach year end. When they spot trends, they will need to be able to break those trends down into performance for a given period of time, such as for the prior month or quarter, necessitating percent measures per calendar period (e.g., month or quarter).

As they investigate and manage to those numbers, they will ultimately need to look at absolute numbers instead of percents (e.g., 0% of the children in residential placement were vaccinated, but in terms of significance, how many children does that represent?). Hence, the absolute numbers for the numerator and denominators are important.

As they investigate reasons for underperformance, they will be looking over the past to spot trends that could provide process improvement techniques for the future. In that case, numbers of patients who did NOT meet the criteria will become more important than the numbers who did (e.g., see Number Not Vaccinated in the figure). Then, as they turn their focus to the future, and develop plans for increasing success rates, the number of outstanding patients who have not met the criteria will become important (e.g., see Number Awaiting Vaccination in the figure).

The capability to quickly access these various measurement components is crucial to leveraging information to improve performance.

The CQM BI Dashboard provides access to all of these measurement components with a single click, sliced by any combination of dimensions, allowing managers and analysts to rapidly identify trends leading to quality improvement. Ease of access to trend information and the capability to rapidly identify pockets of poor quality can be a driving force for quality improvement.


Trend Analysis Tools
The Dashboard makes trend analysis easy by providing a variety of built-in trend analysis tools, including trend lines and forecasts, regression coefficients, and on-the-fly calculation of ratios, percents and differences. The slice and dice capability inherent in the BI Dashboard allows users to easily identify populations of interest for trend analysis.

Patient Populations
The patient population view allows users to rapidly view a list of patients in any carved out population. For example, planning future vaccinations can be achieved by listing patients awaiting vaccination by vaccination type, city, living situation, primary language or other criteria.

Patient Registry
The lowest level of drilldown provides a patient registry, showing key information needed to manage at the patient level for each of the clinical quality measures. For example, the registry for the immunization CQM shows a complete history of vaccinations, medication allergies, diagnoses and diagnosis resolutions applicable to immunization.

       
   
    Healthcare BI Dashboard
 ·Clinical Quality-Measures
 ·Dashboard Architecture
 ·Behavioral Heathcare Dashboard
 ·Data Presentation
 ·Behavioral Healthcare Best-Practices
 ·Technical Characteristics
 ·SaaS or Native Model
 ·Actionable Reports
 ·Getting Started
    Healthcare EHR Systems
    Behavioral KPI Whitepaper
    Business Intelligence (BI)
    Executive Dashboards & Key Performance Indicators (KPI)


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