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More PopHealth Lessons Learned

In the March HIT Standards Committee we highlighted 3 gaps in the standards needed to calculate quality metrics automatically from EHRs

1.  A longitudinal (not encounter level) patient summary format to transmit appropriate data elements from an EHR to a quality measurement entity

2.  A batch reporting format to transmit data elements for multiple patients to a quality measurement entity

3.  Although PQRI XML and QRDA have been suggested for reporting data between quality measurement entities and organizations that use this data for payment/compliance, there is not a widely adopted standard for quality reporting in production today.

As I wrote in a wrote in a previous post, ONC/MITRE/BIDMC/Massachusetts eHealth collaborative  worked together to evaluate the PopHealth tool with 2 million Continuity of Care Documents.

The full results of that analysis are now available and here’s the document for public circulation.

Key lessons learned include:

1.  The CCD is a  “post-encounter message” not a lifetime clinical summary optimized for quality measurement

The CCD/C32 was designed as an encounter level summary from a single organization.    Each patient will have multiple CCD/C32s but there are no well defined process for merging CCDs from multiple institutions and applications.   popHealth was expecting each C32 to contain the complete clinical history for one patient since quality measures are often focused on longitudinal treatment of patient, not a single encounter.

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