Using Health Information Exchange Data Boosts Quality Reporting

Integrating health information exchange (HIE) data with EHR data provides a more accurate and complete view of quality reporting than patient data from one hospital source, according to a study published in the Journal of the American Medical Informatics Association (JAMIA).

Health systems can improve patient care, report performance, and healthcare provider reimbursement by utilizing clinical quality measures. Since EHR adoption has significantly increased over the last decade, healthcare facilities must develop and submit EHR quality reports.

Inaccurate or fragmented patient data can have a significant impact on patient safety and data completeness, interoperability, and data accuracy are major barriers of quality data reporting.

The research team evaluated 53 Kansas Health Information Network-connected healthcare facilities with over 100 monthly clinical document exchanges to evaluate how electronic clinical quality measurement differs when comparing individual organization data collection against longitudinal data collection by a statewide HIE.

The researchers assessed 14 clinical quality measures, including breast cancer screenings and colon cancer screenings, for over 5,000 patients by leveraging individual EHR data and comparing it to when researchers integrated HIE data to EHR data.

After integrating HIE data, the study revealed significant differences in 13 of 14 clinical measures. The HIE integration impacted 19 percent of patients in 42 of 53 participating healthcare facilities.

Overall, 79 percent of patients received care at more than one facility and the researchers compared nearly 13,000 clinical quality measure calculations from the original hospital against HIE data integration. Fifteen percent of quality measure calculations changed after integrating HIE data, which impacted the 19 percent of patients.  

The study revealed that HIE data provides a more complete and accurate view of quality reporting than EHR data from one healthcare facility.

Although the study authors said prior research has shown that patient care is fragmented and an EHR may exclude relevant patient data, this study revealed that adding standards-based data through an HIE can modify quality measurement.

“Including longitudinal data often results in performance rate improvements, although any change can be viewed as more complete measure calculation that includes all relevant data,” wrote the study authors.

“Reviewing these improvements and interoperability’s role in quality calculation contextualize the impact to efficient care, patient safety, and value-based payment programs. Policy implications from these findings have the potential to improve the accuracy and robustness of future quality measurement,” the study authors continued.

Clinician burnout is commonly associated with quality reporting due to increased time and costs.

“While the primary intent of this research was to determine whether there was a significant difference in quality measurement when longitudinal data from an HIE were included, this approach has the potential to reduce administrative effort and decouple eCQM calculation from any specific EHR,” explained the study authors.

The researchers said programs that inspire data interoperability could improve health system quality calculation. Additionally, consistent and accurate reporting methods can provide quality measurement consistency. Finally, improving patient data sharing can boost measure calculation through an alternative infrastructure, the researchers recommended.

Although EHRs are required to calculate quality measures, the study authors said some calculate differently compared to multisource, longitudinal calculations.

“While this is a natural consequence of patients seeing multiple providers annually and incomplete interoperability, this study finds that data sharing affects patient safety and measures routinely used in value-based payment models,” concluded the study authors.

“Therefore, programs that incorporate longitudinal data are more likely to result in accurate quality measurement. Federal policies that promote data interoperability and the harmonization of reporting methods may result in more accurate and representative quality measurement in the coming years.”