The National Quality Forum

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The NQFs Perspective

Panel Discussion on Measurement and Research
INQRI Webinar April13, 2009
Marybeth Farquhar, PhD, MSN, RN Managing
Director, Performance Measures National Quality
Forum
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Presentation At A Glance

• The Administrations Emerging Quality Agenda
• NQFs Role
• Congressional Directive DHHS Contract
• NQFs Major Areas of Work The Road Ahead
• National Priorities Partnership
• Portfolio of Performance Measures
• Building EHRs/PHRs to Support Performance
  Improvement
• Healthcare Reform Stand For Quality

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The Administrations Emerging Quality Agenda

• Stimulus Package (ARRA) Roughly 1 in 5 goes
  to health care
• Comparative effectiveness (1.1B)
• HIT (19.2B)
• Prevention/wellness (1B)
• HAI (50M)
• Hospice delay reductions in Medicare payments

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The Administrations Emerging Quality Agenda

• 2010 Budget
• 30-day readmissions
• Hospitals to receive bundled payment including
  30-day post acute care
• Payment
• Continued P4P for Hospitals (12B savings over 10
  yrs)
• Turbocharged Payment Demos

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NQF Role

• July 2008 Congressional Directive to DHHS
• Contract with consensus standard-setting body to
• Set national priorities
• Endorse and maintain measures
• Promote development of EHRs capable of supporting
  quality
• January 2009
• NQF received contract
• 10M per year for up to 4 years

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(No Transcript)
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National Priorities

• Population health
• - Key preventive services
• - Healthy lifestyle behaviors
• Safety
• Hospital-level mortality rates
• Serious adverse events
• Healthcare-Acquired Infections
• Care Coordination
• Medication reconciliation
• Preventable hospital readmissions
• Preventable emergency department visits

• Patient/family engagement
• Informed decision-making
• Patient experience of care
• Patient self-management
• Palliative Care
• Relief of physical symptoms
• Help with psychological, social and spiritual
  needs
• Communication regarding treatment options,
  prognosis
• Access to palliative care services
• Overuse
• 9 major areas

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National Priorities

• Two-dimensional Framework
• NPP Crosscutting Priorities
• DHHS Contract Requests Prioritization of Leading
  Conditions (i.e., Patient-Focused Episodes)

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Patient- Focused Episode Framework Low Back
Pain

• Trajectory 1 (T1) Returning back to work
  assuming normal activities of daily living
• Focus on
• Quality of Life
• Functional Status
• Patient-generated goals
• Education prevention of future episodes

Diagnosis Initial Management
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Building EHRs to Support Quality
Acknowledgement Paul Tang, MD
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Measures to Assess Effective Use of EHRs

• e-prescribing
• decision support (including stand-alone/non-EHR
  applications)
• in EHR
• EHR interoperability
• adoption of CCHIT or core-functional EHR
• receive labs electronically
• care management
• at point of care
• between visits
• quality reporting registry
• local
• national
• medical home

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Health IT
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Stand for Quality

• Building a Foundation for High Quality,
  Affordable Health Care Linking Performance
  Measurement to Health Reform.
• 160 supporting organizations
• Six key recommendations
• Set national priorities and provide coordination
• Endorse/maintain measures
• Support measure development
• Establish multi-stakeholder consultative process
  on use of measures
• Data aggregation and reporting
• Identify best practices for quality improvement
• www.standforquality.org

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• For More Information
• mfarquhar_at_qualityforum.org
• www.qualityforum.org