The Congressional Budget Office’s (CBO) Working Paper released December 2017 https://www.cbo.gov titled “Issues and Challenges in Measuring and Improving the Quality of Health Care” was authored by Tamara Beth Hayford and Jared Lane Maeda at CBO.
The authors with a number of contributors looked at areas affecting the construction of quality measures and found that the reliability of quality measures depends critically on the accuracy of the underlying data.
One section of the Working Paper discusses types of data and how important it is to use data that both patients and physicians find essential to produce high quality healthcare. In addition, the Working Paper also notes how important it is to achieve interoperability when exchanging data so the information can prove to be more valuable to both patients and doctors
According to the working paper, one specific source called administrative data obtained from insurers’ enrollment and claims files, is readily available and inexpensive to use in an electronic format for large populations.
However, administrative data can lack the clinical detail about patients and their symptoms, history, complications, and test results. The problem is that this information is required for many quality measures.
Very often administrative data is used in conjunction with data from medical records since these records contain more detailed clinical information. However, since medical records can be less standardized plus the fact that the interoperability issues affecting different EHR systems can also limit the usefulness of the system.
Registries is another source that can be used but sometimes registries may not have standardized definitions or data elements. It can also be difficult to collect data from different settings of care, plus health information technology systems are not always interoperable with registries.
Patient surveys have also been found to be useful as they can capture information from patients. The one limitation in using patient surveys is they typically have low patient response rates which can influence how well they represent the experiences of the entire target population.
Go to https://www.cbo.gov/publication/53387 to view “Working Paper 2017-10” released by the Congressional Budget Office. The views in the report are not necessarily interpreted as CBOs since this working paper has not been subject to CBOs regular review and editing process.