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Engaging Patients with Personal Health IT for Quality
Published in Jan Oldenburg, Dave Chase, Kate T. Christensen, Brad Tritle, Engage!, 2020
Despite a sustained focus on measuring and improving quality over more than a decade, it is difficult to define precisely. One widely-accepted definition of quality from the IOM’s “Crossing the Quality Chasm” report is “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”2 Quality is complex for several reasons. First, different stakeholders define it differently. From a patient perspective, a trusting relationship, a delightful office visit experience, a reduction in procedural risk, an accurate diagnosis, and an appropriate and safe treatment choice are all indicators of quality. To a provider, reducing no-shows, adhering to clinical guidelines, thorough documentation, and improvement in Healthcare Effectiveness Data and Information Set (HEDIS) measures are all measures of quality and illustrate the broad range of quality indicators. Payers and public policy leaders measure quality in terms of reduced hospitalization rates and increased patient activity levels. Quality is both what the healthcare system should do (e.g., high vaccination rates) and the defects it should avoid (e.g., wrong-side surgery). In some cases, it can be measured objectively (e.g., percent of lab results reported to the patient within five business days), but subjective measures matter, too (e.g., level of patient satisfaction with the appointment-making process).
The Employer’s Role in Lifestyle Medicine
Published in James M. Rippe, Lifestyle Medicine, 2019
It’s not enough to judge the success of lifestyle management modifications based on basic screening and process parameters. Instead, measurable improvements in health outcomes are the target. Nearly all employers and healthcare plans rate a patient’s care using the Healthcare Effectiveness Data and Information Set (HEDIS). In cases of people with diabetes, HEDIS requires physicians to quantify and track data on a patient’s hemoglobin A1c levels, as well as the condition of the feet, eyes, urine, and kidneys. But this is often used as simply a “check the box” process; it does not measure whether the patient is any healthier over time. To really make an impact, it’s important to measure lifestyle behavior changes to identify actual outcomes of improved health—and ultimately, to tie them to employee performance as well as direct and indirect costs. Employers who measure disease reversals and reductions in medication use linked to improved health status for their employees will achieve greater impact from their programs than those who measure only clinic visits and screening parameters.
Vision Impairment and Its Management in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Rajeev S. Ramchandran, Holly B. Hindman, Silvia Sörensen
Due to the importance of regular eye examinations in this population, the American Academy of Ophthalmology recommends yearly dilated eye examinations for all persons diagnosed with DM. Annual dilated eye examinations are also an important Healthcare Effectiveness Data and Information Set (HEDIS) criteria developed by the National Committee for Quality Assurance (NCQA) used by federal agencies and health insurance companies to measure the quality of care provided to the diabetic population. Furthermore, regular eye examinations are advocated for all adults, especially after the age of 30 to detect and timely treat vision-threatening conditions such as macular degeneration, glaucoma, cataract, and need for glasses.
Predictors of substance use disorder treatment initiation and engagement among adolescents enrolled in Medicaid
Published in Substance Abuse, 2022
Laura J. Chavez, Danielle L. Steelesmith, Jeffrey A. Bridge, Cynthia A. Fontanella
The National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set (HEDIS) includes a wide-ranging set of performance measures that can be used to compare the quality of care across health plans for multiple domains.8 The HEDIS Initiation and Engagement in Treatment (IET) performance measure assesses health plan performance on delivering timely treatment for SUD among health plan members aged 13 and older.9 The IET measure is based on foundational work by the Washington Circle, which developed the two-part process measure to evaluate the quality of SUD care.10 Health plan members with a qualifying SUD diagnosis are assessed to determine whether treatment was “initiated” within 14 days of diagnosis and among those who initiate SUD treatment, “engagement” within 30 days is also assessed. The HEDIS IET measures have been studied extensively in adults,11–16 and there is evidence that system-level changes in SUD care delivery can produce both improvements in HEDIS measure performance as well as improved clinical outcomes.
Adherence and persistence among patients with major depressive disorder enrolled in the vortioxetine tAccess Patient Support Program
Published in Current Medical Research and Opinion, 2021
Debra F. Lawrence, Janna Manjelievskaia, Lambros Chrones, Maggie McCue, Maëlys Touya
The National Committee for Quality Assurance (NCQA) collects data from health plans and other healthcare organizations on a variety of measures included in its Healthcare Effectiveness Data and Information Set (HEDIS) as a way to evaluate the performance of these plans14. The NCQA’s HEDIS is one of the healthcare industry’s most widely used performance improvement tools, reported in plans insuring 191 million people14. HEDIS includes two performance measures related to antidepressant medication management (AMM): the percentage of adults who remained on antidepressant medication for at least 84 days (12 weeks), indicating the effective acute-phase treatment, and the percentage of adults who remained on antidepressant medication for at least 180 days (6 months), indicating effective continuation-phase treatment15. In 2017, the NCQA estimated that among patients enrolled in commercial health maintenance organization (HMO) plans, the HEDIS AMM criteria for persistence to antidepressant medication were met by 67.8% of patients at 84 days (12 weeks) and 51.8% at 180 days (6 months)15. Similar results were observed among patients enrolled in Medicare HMO plans, but only 53.9% of patients on Medicaid were persistent at 84 days and 38.6% at 180 days15.
Predictors of Healthcare Effectiveness Data and Information Set (HEDIS) treatment initiation and engagement among patients with opioid use disorder across 7 health systems
Published in Substance Abuse, 2019
Cynthia I. Campbell, Constance Weisner, Ingrid A. Binswanger, Gwen T. Lapham, Brian K. Ahmedani, Bobbi Jo H. Yarborough, Irina V. Haller, Andrea Altschuler, Rulin C. Hechter, Amy M. Loree, Andrea H. Kline-Simon
The Healthcare Effectiveness Data and Information Set (HEDIS), developed by the National Committee for Quality Assurance (NCQA), is a widely used set of performance measures across many health conditions that can be used by health systems to improve quality of care.9 The HEDIS measure of “Initiation and Engagement of Alcohol and Other Drug Dependence Treatment” reflects access to AOD treatment. Overall, HEDIS initiation and engagement measures have identified low initiation and engagement for populations with AOD disorders.10–13 However, the widespread concern generated by the opioid crisis may lead to a heightened awareness of the importance of treatment for patients with OUD. The study aim is to examine the HEDIS initiation and engagement measures specifically among patients with OUD from diverse health systems, and to identify which patient characteristics and care settings may be related to initiation and engagement. Identifying patients and settings that are associated with a lower likelihood of initiating and engaging in treatment can inform providers and health systems where to focus efforts to support improving access to care for this high-need population.