Enhancing performance measurement - NCQA's road map for a health information framework

Measuring the quality of health care delivery is one of the most critical c hallenges facing US health care. Performance measurement can be used to tra ck the quality of care that health plans and medical groups deliver, but ef fective performance measurement requires timely access to detailed and accu rate data. In 1996, the National Committee for Quality Assurance (NCQA) com missioned a report to learn what actions would improve health plans' capaci ty to electronically report performance data for the Health Plan Employer D ata and Information Set (HEDIS). Tracking clinical performance will require not just clinical data stored in information systems, but an integrated he alth information framework. Seven features are essential to this framework: (1) it specifies data elements; (2) it establishes linkage capability amon g data elements and records; (3) it standardizes the element definitions; ( 4) it is automated to the greatest possible extent; (5) it specifies proced ures for continually assessing data quality; (6) it maintains strict contro ls for protecting security and confidentiality of the data; and (7) it spec ifies protocols for sharing data across institutions under appropriate and well-defined circumstances. Health plans should anticipate the use of compu terized patient records and prepare their data management for an informatio n framework by (1) expanding and improving the capture and use of currently available data; (2) creating an environment that rewards the automation of data; (3) improving the quality of currently automated data; (4) implement ing national standards; (5) improving clinical data management practices; ( 6) establishing a clear commitment to protecting the confidentiality of enr ollee information; and (7) careful capital planning, Health care purchasers can provide the impetus for implementing the information framework if they demand detailed, accurate data on the quality of care.