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WASHINGTON, Aug. 29 /PRNewswire-USNewswire/ -- To improve quality and efficiency and reduce errors and unnecessary treatments across the healthcare system, the National Quality Forum (NQF) has endorsed nine new national voluntary consensus standards for health information technology (HIT) in the areas of electronic prescribing, electronic health record (EHR) interoperability, care management, quality registries, and the medical home. These HIT structural measures are intended to help providers assess the efficiency and standardization of current HIT systems and identify areas where additional HIT tools can be used.

Adoption of HIT by clinicians has been shown to reduce medical errors by increasing access to information thereby improving response times to abnormal results, eliminating repetitive testing and providing clinical decision- support tools to facilitate evidence-based care.

Evidence has shown a decrease in medication errors by up to 20 percent and a decrease in per admission costs by more than 12 percent when clinicians use HIT.

"If we hope to achieve high-quality, patient-centered care, we need interoperable HIT that can help us share information electronically and track patients throughout the delivery system -- all of which can reduce errors and overuse and increase measurement across the continuum of care," said NQF President and CEO Janet Corrigan. "These newly endorsed measures can provide important information on effective use of health IT for both early adopters of HIT and those who are just beginning to implement HIT systems."

Blackford Middleton, MD, director of clinical informatics research and development at Partner HealthCare System in Massachusetts, and Joel Slackman, MS, managing director of the Blue Cross Blue Shield Association, co-chaired NQF's steering committee on HIT structural measures.

"NQF-endorsed HIT structural measures will help the practice of medicine move forward with the adoption of information technology in healthcare," said Middleton. "This allows us to better understand how widely healthcare information technology is being used in care delivery, and is a critical first step toward transforming healthcare."

E-Prescribing

Electronic prescribing improves quality by reducing legibility errors, providing interactions and dosing alerts, and reducing costs by comparing equally effective alternative medications. The two e-prescribing measures endorsed by NQF encourage the adoption of either a stand-alone e-prescribing tool for providers without EHR systems or the enhanced use of e-prescribing within an EHR for early adopters of HIT.

Electronic prescribing measures endorsed by NQF were developed by Quality Insights of Pennsylvania (QIP) and the New York Department of Health and Mental Hygiene.

Interoperability of EHRs

The interoperability of electronic health records -- EHRs that can share information between clinics, offices, and laboratories -- improves quality by increasing timely, efficient, evidence-based care. NQF endorsed two measures to increase adoption of interoperable EHRs: the first measures adoption of an EHR to manage clinical data within a practice, the second measures receipt of clinical data such as external laboratory results into an EHR. NQF aligned these measures with Certification Commission for Health Care Information Technology (CCHIT) recommended EHR- certification criteria whenever possible.

Measures for the interoperability of EHRs endorsed by NQF were developed by the Centers for Medicare & Medicaid Services (CMS) and QIP.

Care Management

Electronic care management tools improve quality by improving patient- centered care that is coordinated and evidence-based. Too often information about patients falls through cracks in the delivery system.

Both of the care management structural measures endorsed by NQF measure the use of HIT to identify specific patients in need of care, track their preferences and laboratory results, and assist the clinician in providing evidence-based care according to national guidelines using automated alerts and reminders. To measure care management across and between settings, the first measures HIT used during a patient-clinician visit and the second measures clinical results between visits.

These care management measures endorsed by NQF were developed by CMS and QIP.

Quality Registries

Sharing information through electronic quality registries allows for increased care coordination by tracking patients in need of care throughout the delivery system and giving feedback to providers. Registries also assist in data collection on the safety and effectiveness of care to guide quality improvement efforts. The two structural measures for quality registries endorsed by NQF assess clinician participation in quality registries at the local, statewide, and national levels.

  These measures endorsed by NQF were developed by CMS.

  Medical Home

The medical home is a broad model of primary care that aims to improve quality by providing coordinated, effective, continuous, patient-centered care. Many of the measures endorsed by NQF in this set of HIT structural measures assess technology tools that are central for creating a medical home that is patient-centered and drives toward coordinated care.

NQF has endorsed a Medical Home System Survey that will allow clinicians to assess whether their practices are functioning as a medical home by providing ongoing, coordinated, and patient-centered care. The survey specifically includes measurement of key HIT functionalities, such as the use of electronic-based charting tools to organize clinical information, the use of tracking tests and referrals, and the adoption and implementation of evidence-based guidelines.

The Medical Home System Survey endorsed by NQF was developed by the National Committee for Quality Assurance (NCQA).

How to Appeal

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by notifying NQF in writing via e-mail no later than September 27 (appeals@qualityforum.org). For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

  Funding
  This work was conducted under a contract from CMS.

  MEASURES ENDORSED BY NQF

Please visit our website at http://www.qualityforum.org/ to read the full specifications for all of the new NQF-endorsed voluntary consensus standards and read NQF's research recommendations.

  Electronic prescribing
  -- Adoption of medication e-prescribing

-- HER with EDI prescribing used in encounters where a prescribing event occurred

  Interoperable HER
  -- Adoption of Health Information Technology

-- The Ability for Providers with HIT to Receive Laboratory Data Electronically Directly into their Qualified/Certified EHR System as Discrete Searchable Data Elements

Care Management

-- The Ability to use Health Information Technology to Perform Care Management at the Point of Care

  -- Tracking of Clinical Results Between Visits

  Quality Registry

-- Participation in a Practice-based or individual Quality Database Registry with a standard measure set

-- Participation by a physician or other clinician in systematic clinical database registry that includes consensus endorsed quality measures

  Medical Home
  -- Medical home system survey

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.