Indiana HIE Lets Public See Quality Metrics - InformationWeek
Government // Leadership
09:41 AM

Indiana HIE Lets Public See Quality Metrics

Once shy about sharing data, leading health information exchange now posts public scorecard that compares doctors' success treating diabetes, heart problems and other conditions.

8 Health Information Exchanges Lead The Way
8 Health Information Exchanges Lead The Way
(click image for larger for slideshow)
The Indiana Health Information Exchange (IHIE) has launched the first practice-level public quality reporting site in Indiana. More than 750 Indiana physicians from 174 practice sites around the state have agreed to post their clinical quality measure scores on the website of IHIE's Quality Health First (QHF) program.

The scorecard shows how well each practice does on 21 measures compared to other practices in their region and the entire state. The clinical measures include process and outcome metrics for treating such conditions as diabetes, heart health and respiratory issues, as well as results for women's and children's health care.

In a statement, Harold J. Apple, president and CEO of IHIE, one of the leading information exchanges in the country, said, "QHF was developed as a tool to help physicians better manage and monitor the care provided to patients with chronic diseases. Reporting these quality scores is a significant milestone for physician practices seeking to demonstrate their commitment to improving the quality of care provided to patients."

[ Practice management software keeps the medical office running smoothly. For a closer look at KLAS' top-ranked systems, see 10 Top Medical Practice Management Software Systems. ]

Indiana physicians apparently were not always eager to participate in public quality reporting. Several years ago, the Robert Wood Johnson Foundation (RWJF) wanted to include IHIE in its Aligning Forces for Quality program, which now encompasses 16 communities across the U.S., recalled Michael Painter, M.D., senior program officer for RWJF, in an interview. But IHIE would not commit to publishing quality reports, which was one of the program requirements, so RWJF looked elsewhere, Painter said.

Josh Nelson, M.D., chief medical officer of IHIE, told InformationWeek that he had no knowledge of that episode, which occurred before he joined the organization. The recent decision to publish quality reports, he said, was made by all the stakeholders in Quality Health First, including provider groups, health plans and employers.

Previously, there was community-wide reporting that showed how well all providers were doing on the quality measures, he said. Payers and employers believed that practice-level reporting would be meaningful to consumers, and the physician groups agreed that it would help them improve performance.

Although some solo practices are included among the reporting providers, QHF's stakeholders chose not to report individual doctors' numbers. One reason, Nelson said, is that some physicians don't have enough patients with particular conditions to make measures related to those conditions statistically significant. "If we had gone to the individual doctors, we would have lost a lot of measures," he said.

Only primary care practices are included in the report card because specialists don't participate in the QHF, he noted. The data is risk-adjusted for each practice's payer mix, broken down into commercial, Medicare, and Medicaid patients.

Anthem Blue Cross Blue Shield, the largest payer in the market, is giving bonuses to practices that improve their quality scores, said Nelson. But although plans and employers are letting their members and workers know about the quality reports, he was not aware of any effort to use the data to "tier" providers by quality scores.

The physician practices enter the quality data on a secure website. Only some of the participating groups -- primarily the larger ones -- have electronic health records, Nelson said. Other practices are doing manual chart reviews to gather the data.

Payer claims data is combined with the clinical data in the report cards, he added. If physicians notice that they provided a service but it's not indicated in the claims information, their staff can add the missing data to the database on the website. The doctors also have an opportunity to review the reports before they're published.

Storing and protecting data are critical components of any successful cloud solution. Join our webcast, Cloud Storage Drivers: Auto-provisioning, Virtualization, Encryption, to stay ahead of the curve on automated and self-service storage, enterprise class data protection and service level management. Watch now or bookmark for later.

Comment  | 
Print  | 
More Insights
Threaded  |  Newest First  |  Oldest First
User Rank: Apprentice
12/11/2012 | 10:12:04 PM
re: Indiana HIE Lets Public See Quality Metrics
I know this is a sensitive issue for many physicians, who don't believe it's fair from them to be compared to their colleagues, especially if their case mix is different and they are seeing sicker patients.

But the reality is, healthcare is a multi-trillion dollar business that's out of control. Everyone needs to be measured and evaluated to get it back on track.

Paul Cerrato
InformationWeek Healthcare
How Enterprises Are Attacking the IT Security Enterprise
How Enterprises Are Attacking the IT Security Enterprise
To learn more about what organizations are doing to tackle attacks and threats we surveyed a group of 300 IT and infosec professionals to find out what their biggest IT security challenges are and what they're doing to defend against today's threats. Download the report to see what they're saying.
Register for InformationWeek Newsletters
White Papers
Current Issue
2017 State of the Cloud Report
As the use of public cloud becomes a given, IT leaders must navigate the transition and advocate for management tools or architectures that allow them to realize the benefits they seek. Download this report to explore the issues and how to best leverage the cloud moving forward.
Twitter Feed
InformationWeek Radio
Archived InformationWeek Radio
Join us for a roundup of the top stories on for the week of November 6, 2016. We'll be talking with the editors and correspondents who brought you the top stories of the week to get the "story behind the story."
Sponsored Live Streaming Video
Everything You've Been Told About Mobility Is Wrong
Attend this video symposium with Sean Wisdom, Global Director of Mobility Solutions, and learn about how you can harness powerful new products to mobilize your business potential.
Flash Poll