Measurement Approach | Specific Measure Concepts | Data Source(s) |
---|---|---|
Use Meaningful Use measure data elements in new measures of care coordination | Go to Tables 1, 2, and 3 for lists of data elements | Certified EHRs from providers and hospitals participating in the Meaningful Use incentive program |
Use CCD/CCR messages to confirm transmission of key pieces of information during care transitions | CCD/CCR transmitted following hospital discharge or referral to specialist CCD/CCR sections for the medication list, problem list, lab results included among information transmitted. Contents of CCD/CCR not examined) |
Numerator: EHR or HIE* Denominator: claims data (APCD, HIE* [if includes claims data], payer files) |
Use EHR data to confirm inclusion of key information from other health care settings within primary care record | Primary care EHR contains information on hospitalization (e.g., discharge summary) or specialist visits (e.g., clinical summary) that occurred outside the primary care clinic system |
Numerator: EHR Denominator: claims data (APCD, HIE* [if includes claims data], payer files) |
Use EHR audit files to evaluate whether information transferred from other settings is viewed by providers. |
Discharge summary received from hospital is opened by PCP or nurse within certain timeframe. Clinical summary from specialist consult is viewed before or during follow-up visit. |
Numerator and denominator: EHR audit files |
Use claims data to confirm follow-up care occurred within expected time frame | Percent of patients discharged from the hospital with certain conditions who have a visit with an outpatient provider within a certain timeframe | Numerator and denominator: APCDs or HIE* (if includes claims data) or payer files |
Use claims data to examine instances of redundant testing |
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Numerator and denominator: APCDs or HIE* (if includes claims data) or payer files Would be enhanced by addition of clinical data from EHR or HIE* |
APCD—all-payer claims database; CCD—continuity of care document; CCR—continuity of care record; EHR—electronic health record; HIE—health information exchange
*HIEs are only a data source if they include a data repository that stores data rather than just transmitting it.