Standardize to really make EHR meaningful
- Standardize Vocabulary & Terminology
- Standardize Quality Measure Strategy to incentivize Value
- Standardize Error, Harm & Waste Standardization & Reporting
Standardization of Vocabulary and Terminology
- Data Loss
- Poor UX/UI Design inhibits
- Workflow based on Regulatory requirements
- Workflow based on Billing requirements
- Physicians input data but never reap the benefits
- Data Normalization
- Poor intake of Data
- Requires massive normalization post collection
- Significant risk of error
- We are not even able to correctly identify patients
- Data Portability
- Interoperability depends on Standards at a National level
Outrageous: What if less than 10% of retail products had a UPC code?
What would be the impact to retail data analysis, supply chain and inventory management, consumer purchasing patterns, product safety, etc?
What if the cashier had to hand-enter into a computer a description of all the product information you were buying?
The Need to Normalize Data in Healthcare is... Abnormal - Dale Sanders
Standardize Quality Measure Strategy to Incentivize Value
Normalizing High-Value Care: Findings of the National Quality Task Force
National Quality Task Force Findings:
What is primarily missing is not progress in measurement, but progress in results.
Changes in culture, investment, leadership, and even the distribution of power are even more important than measurement alone.
Despite equity being a major goal from Crossing the Quality Chasm, health care outcomes have fallen appallingly short in this regard.
Current Limitations of the Quality Movement
- High-value care is far from universal
- Health equity concerns are growing
- Care is increasingly fragmented
- Care is not person-centered
Quality Of Care Can And Must Be Measured To Drive Improvement
Quality Measure Development and Associated Spending by the Centers for Medicare & Medicaid Services
We spend a lot of money and time in developing Standards that we do not implement
Those Quality Standards that are implement do not drive the objectives
CMS currently lacks a strategy to systematically evaluate whether their quality measures improve the delivery of care and health outcomes
Types of Quality Measures Implemented or Finalized for Use in Centers for Medicare & Medicaid Services (CMS) Programs
Most commonly process (n = 409) or outcome (n = 236) measures:
We are spending twice the amount of money to improve process and the healthcare spending is still going high.
We are spending money on the outcome, but no clear strategy to measure the result.
The total inflation-adjusted amount of money awarded by the CMS between 2008 and 2018 to develop and maintain quality measures was $1,313,500,000. Thirty-five organizations received award contracts, and the top 5 organizations were awarded $872.9 million.
Too many data Standards
Standardize Error, Harm & Waste Standardization & Reporting
We need standardized reporting of the following:
Standardize Data Shift and its implications
Data changes due to multiple reasons. We need to have a standardized approach to measuring and reporting Data Shifts:
- Changes in Technology
- Changes in Population and Setting
- Changes in Behavior