Advancing Quality Measurement and Care Improvement with Health Information Exchan

项目总结/摘要 该提案的目标是创建和验证启用健康信息交换（HIE）的 两个拟议的国家质量论坛（NQF）电子质量措施的版本， 可预防急诊科（艾德）就诊：1）72小时内返回艾德（艾德 返回）和2）频繁的艾德用户，然后评估其对目前使用的干预措施的影响 只有“孤立的”机构特定数据。该项目将与纽约临床 信息交换（NYCLIX），一个现有的HIE，跨越了新的大部分主要医院， 约克市（纽约市）。 目前质量衡量方法的一个局限性是，它通常是机构性的， 具体而言，仅限于单个供应商组织。HIE的出现提供了一个机会， 以新的方式思考质量，并创建新的以患者为中心的质量措施， 无论患者在何处寻求护理。 本提案中的具体假设是：1）基于健康教育的电子质量措施将 允许更好地检测艾德质量保证（QA）病例和频繁的艾德用户，以及2）使用 正在进行的项目中的这些措施将改进艾德质量保证过程， 频繁使用艾德的患者。 该项目的目标是：1）开发和验证基于健康信息交换的工具 支持针对艾德退货和经常使用艾德的用户的新机构间电子质量措施，2） 将新的机构间电子质量措施的性能与当前站点进行比较- 采取定量和定性方法的具体措施; 3）实施新的国际贸易法， 在现有的质量保证和案例管理计划中采用机构电子质量措施， 的影响 主要结局包括72小时返回中捕获的患者数量， 频繁的艾德用户队列，有和没有新的机构间措施。二次 结果包括构成质量问题的72小时退货案件的数量， 实施和不实施新的机构间措施的经常使用艾德的人的就诊次数。

PROJECT SUMMARY/ABSTRACT The goal of this proposal is to create and validate health information exchange (HIE)-enabled versions of two proposed National Quality Forum (NQF) e-Quality measure for potentially preventable emergency department (ED) visits: 1) returns to the ED within 72 hours (ED returns) and 2) frequent ED users, then evaluate their impact on interventions currently using only "siloed" institution-specific data. The project will be implemented with the New York Clinical Information Exchange (NYCLIX), an existing HIE that spans most of the major hospitals in New York City (NYC). One limitation to the current approach to quality measurement is that it is usually institution- specific, limited to a single provider organization. The advent of HIE presents an opportunity to think about quality in new ways and create new patient-centric quality measures that gather data wherever patients seek care. The specific hypotheses in this proposal are that 1) HIE-enabled e-Quality measures will allow better detection of ED quality assurance (QA) cases and frequent ED users and 2) use of these measures in ongoing programs will improve ED QA processes and decrease the number of visits by frequent ED users. The Aims of this project are 1) Develop and validate a health information exchange-based tool to support new inter-institutional e-Quality measures for ED returns and frequent ED users, 2) Compare the performance of the new inter-institutional e-Quality measures to current site- specific measures with quantitative and qualitative methods and 3) Implement the new inter- institutional e-Quality measures in existing QA and case management programs and quantify the impact The primary outcomes include the number of patients captured in the 72-hour return and frequent ED user cohorts with and without the new inter-institutional measures. Secondary outcomes include the number of 72-hour return cases constituting quality issues, and the number of visits by frequent ED users with and without the new inter-institutional measures.