Care coordination has
been recognized as a priority area for improving health care delivery in the
U.S. Robust measures of care coordination processes will be essential tools to
evaluate, guide, and support efforts to understand and improve deficits in care
This report presents an
assessment of the potential for measuring care coordination processes using
data from electronic data sources, in particular from existing and emerging
health information technology (IT) systems such as electronic health records
(EHR), health information exchanges (HIE), and all-payer claims databases
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Prepared by: Stanford University Center for Primary Care and Outcomes Research.
M. McDonald, M.M.
Lonhart, B.S., B.A.
Wilson, A.B., M.P.H.
290-04-0020 (AHRQ SQI-II)
Challenges of Measuring Care Coordination Using Electronic Data and Recommendations to Address Those Challenges
Key Challenge Area 1: Underutilization of Health IT System Capabilities
and Clinical Workflow Barriers
Key Challenge Area 2: Lack of Data Standardization and Limited Health
IT System Interoperability
Key Challenge Area 3: Unknown Clinical Data Quality in Electronic
Key Challenge Area 4: Limitations in Linking Data
Key Challenge Area 5: Technical Hurdles to Accessing Data
Key Challenge Area 6: Business Models That Facilitate
Competition Rather Than Cooperation
Opportunities for Future Measurement of Care Coordination with Electronic Data
Summary of Measurement Opportunities
Appendix A: Methods of Seeking Input About the Potential for Measuring
Care Coordination Using Electronic Data
Appendix B: Group Panel Call Agenda
Appendix C. Glossary and Abbreviations
Appendix D: Additional Sources
We thank Jan Genevro, David Meyers and Mamatha Pancholi of
the Agency for Healthcare Research and Quality for their support of this work.
We wish to thank Sarah Knoop, Bill Cody, John Timm and Daniel Gruhl for
providing background into the health IT field and standards and Ben Wilson and
Oanh Nguyen for their insight and review of draft materials. Finally, we gratefully
acknowledge all those who participated in our expert panel: Hunt Blair, Carmella
Bocchino, Keri Christensen, Joanne Cuny, Aaron Cutshall, Floyd Eisenberg, J.
Michael Fitzmaurice, Valerie Fong, Craig Jones, Melanie Mastanduno, Patrick
Miller, Jon Morrow, Wilson Pace, L. Greg Pawlson, Fred Rachman, Elizabeth
Schofield, Claudia Steiner, Paul Tang and Charlene Underwood. While our
panelists and reviewers are not responsible for the contents of this report,
their knowledge and insight has helped inform and strengthen our work.
AHRQ Publication No. 12-0014-EF
Current as of March 2012
McDonald KM, Schultz E, Chapman T, Davies S, Pineda N, Lonhart J, Schmidt E, Wilson AB. Prospects for Care Coordination Measurement Using Electronic Data Sources. AHRQ Publication No. 12-0014-EF, March 2012. Prepared by Stanford University
under subcontract to Battelle on Contract No. 290-04-0020 (AHRQ SQI-II). Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/prospectscare/index.html