Clinical Quality Measure Exchange is Not Easy

Area of Science:

• Health Services Research
• Health Informatics
• Quality Improvement

Background:

• The Trial of Aggregate Data Exchange for Maintenance of Certification and Raising Quality (TADEx) aimed to assess if quality reporting could be a byproduct of clinical care.
• This study focused on the initial descriptive phase, evaluating the capacity and quality of standardized quality measure exchange from health systems.

Purpose of the Study:

• To test whether quality reporting could be an automatic byproduct of clinical care.
• To assess the capacity and quality of standardized, physician-level quality measure exchange from multiple health systems.

Main Methods:

• Recruited family physicians from 4 health systems with established quality measurement programs.
• Collected standardized, physician-level quality measures from participating physicians.
• Identified and evaluated errors in measure transfer and data delivery for root-cause analysis.

Main Results:

• Participating health systems varied in patient demographics and payer mix.
• 256 family physicians participated, with 5 out of 19 negotiated measures used across all systems.
• Over 15 types of errors were identified, including data delivery breaks and nonsensical results; only one system had no errors.

Conclusions:

• Secure transfer of standardized, physician-level quality measures from health systems with mature processes was challenging.
• Numerous errors necessitated manual intervention, preventing full automation of quality reporting.
• Despite health IT adoption, achieving reliable, automated clinical quality reporting remains a distant goal.