Advancing Quality Measurement and Care Improvement with Health Information Exchan

项目摘要/摘要 本提案的目标是创建和验证启用健康信息交换(HIE) 两个拟议的国家质量论坛(NQF)潜在电子质量衡量标准的版本 可预防的急诊科就诊：1)72小时内返回急诊科 返回)和2)经常使用ED，然后评估他们对当前使用的干预措施的影响 只有“孤立的”特定机构的数据。该项目将与纽约诊所一起实施 信息交换(NYCLIX)，一个现有的HIE，横跨纽约大多数主要医院 纽约市(NYC)。 目前的质量测量方法的一个局限性是，它通常是制度性的- 具体而言，仅限于单个提供商组织。HIE的出现为我们提供了一个机会 以新的方式思考质量，创建以患者为中心的新的质量衡量标准 无论患者在哪里寻求治疗，都可以获得数据。 该提案中的具体假设是：1)启用HIE的电子质量措施将 允许更好地检测ED质量保证(QA)案例和经常使用ED的用户，以及2)使用 正在进行的计划中的这些措施将改进ED QA流程，并减少 经常使用ED的用户的访问量。 该项目的目的是：1)开发和验证一个基于健康信息交换的工具 支持针对教育退货和经常使用教育的机构间电子质量新措施，2) 将新的机构间电子质量措施的表现与目前的网站进行比较- 具体措施，采取定量和定性相结合的方法；3)落实新的 现有QA和案例管理计划中的制度性电子质量衡量标准和量化 其影响 主要结果包括72小时返程中捕获的患者数量和 使用和不使用新的机构间措施的经常教育用户群。次要的 结果包括构成质量问题的72小时退货案例的数量，以及 在实施新的跨机构措施前后，经常使用教育署的人士的访问次数。

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.