Health Quality Measures Systems and Methods

• US 20100235192A1
• Filed: 03/10/2010
• Published: 09/16/2010
• Est. Priority Date: 03/11/2009
• Status: Active Grant

• Current Assignee: NXGN Management, LLC. (NextGen Healthcare, Inc.)
• Original Assignee: NextGen Healthcare Information Systems Incorporated (Quality Systems Incorporated)
• Inventors: George, Jibu, Jarvis, Charlie, Rosenberger, Bryan
• Granted Patent: US 8,924,229 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/0639 Performance analysis of employees; Performance analysis of enterprise or organisation operations
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Systems and methods of exchanging Healthcare Quality Measures (HQM) are disclosed. Healthcare providers can define one or more HQMs by constructing expressions using an expression builder according to a funding organization'"'"'s requirements. Once a measure is derived, it can be converted to a common HQM data format and exchanged with the organization via an intermediary HQM service. The HQM data can then be converted into the organization'"'"'s proprietary format. Thus, HQM data exchanges among providers and organizations are simplified.

Claims

1. A method of reporting a health quality measure (HQM), the method comprising:

providing an HQM agent capable of converting patient data stored on a healthcare provider'"'"'s patient database from a proprietary format to a common HQM data format;

providing a healthcare provider interface coupled to the HQM agent;

allowing a provider to use the healthcare provider interface to define an HQM comprising a denominator portion and a numerator portion, each comprising selection criteria;

deriving the HQM from the denominator portion, numerator portion, and the patient data; and

using the HQM agent to send as least some HQM information pertaining to the derived HQM via a packet switched network to an HQM analysis engine, where the HQM information is packaged in the common HQM format.

2. The method of claim 1, wherein the step of allowing a provider to define an HQM includes authenticating the provider with respect to the HQM analysis engine.

3. The method of claim 1, wherein the step of deriving the HQM is conducted by the HQM agent.

4. The method of claim 1, wherein the step of driving the HQM is conducted by the HQM analysis engine.

5. The method of claim 1, wherein the step of deriving the HQM includes calculating a numerator representing a number of encounters in the patient data that satisfy the selection criteria of the numerator portion, and calculating a denominator representing a number of encounters in the patient data that satisfy the selection criteria of the denominator portion.

6. The method of claim 5, further comprising calculating the HQM as a ratio of the numerator to the denominator.

7. The method of claim 1, further comprising using the HQM agent to generate a plurality of lists containing encounter data entries obtained from the patient data where each of the entries represents a encounter that satisfy individual selection criterion of the selection criteria from at least one of numerator portion and the denominator portion.

8. The method of claim 7, wherein the HQM information comprises at least some of the plurality of lists.

9. The method of claim 1, wherein the step of allowing the provider to define an HQM includes allowing the provider to drag and drop elements of selection criteria within the provider interface to form the HQM.

10. The method of claim 1, further comprising automatically sending an HQM report having the HQM to a funding organization, where the report is automatically formatted according to the organization'"'"'s requirements.

11. A healthcare quality measure (HQM) analysis engine, the engine comprising:

an HQM database storing HQM data in a common HQM data format where the HQM data represents patient data obtained from a plurality of healthcare providers, each using a proprietary data format;

a network interface configured to communicatively couple to the healthcare providers via a packet switched network;

an HQM analysis module (1) configured to generate one or more lists containing entries representing encounter data from the HQM data corresponding to HQM selection criteria, and (2) derive a measure based on the lists; and

a HQM reporting module configured to present an HQM report having the measure to a remote healthcare organization via the network interface.

12. The engine of claim 11, wherein the lists are stored within the HQM database.

13. The engine of claim 11, further comprising a list processing module configure to merge two or more lists into a single list according to one or more selection criterion of the HQM selection criteria.

14. The engine of claim 11, wherein the HQM database stores one or more measure requirements from a plurality of remote healthcare organizations.

15. The engine of claim 11, further comprising an HQM data lock module configured to restrict access to a remote healthcare provider'"'"'s patient data.