Health quality measures systems and methods

• US 8,682,691 B2
• Filed: 09/16/2011
• Issued: 03/25/2014
• Est. Priority Date: 03/11/2009
• Status: Expired due to Fees

• Current Assignee: NXGN Management, LLC. (NextGen Healthcare, Inc.)
• Original Assignee: QSI Management, LLC (NextGen Healthcare, Inc.)
• Inventors: George, Jibu, Rosenberger, Bryan, Jarvis, Charlie
• Primary Examiner(s): PAULS, JOHN A
• Application Number:
  US13/234,999
• Publication Number:
  US 20120065998A1
• Time in Patent Office: 921 Days
• Field of Search: 705/2, 705/3, 709/246, 395/800.18
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• 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

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. The expression builder advantageously allows the Healthcare provider to build measure expressions without the need to know a complex programming language. 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 health quality measures (HQMs) to a funding organization, the method comprising:

providing access to an HQM client 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 organization interface coupled to the HQM client;

receiving, by the HQM client, first patient data in a first proprietary format from a first provider and second patient data in a second proprietary format from a second provider;

generating, by the HQM client, first normalized patient data and second normalized patient data by normalizing the first and second patient data from their respective first and second proprietary formats to the common HQM data format;

defining an HQM expression for generating HQMs based on different patient data types according to requirements set forth by the funding organization;

deriving, by the HQM client, a plurality of first HQMs for the first provider and a plurality of second HQMs for the second provider according to the HQM expression and based on the different patient data types, wherein the plurality of first HQMs are derived from the first normalized patient data and the plurality of second HQMs are derived from the second normalized patient data;

generating, by the HQM client, a presentation package comprising the plurality of first and second HQMs and the normalized first and second patient data; and

presenting the package to the funding organization.

2. The method of claim 1, further comprising authenticating the funding organization with respect to the HQM client.

3. The method of claim 1, wherein the HQM expression is defined by the first and second providers.

4. The method of claim 3, wherein the step of defining the HQM expression comprises allowing the first provider to drag and drop elements of selection criteria to form the HQM expression.

5. The method of claim 1, wherein the HQM expression is defined by the funding organization.

6. The method of claim 1, wherein the step of deriving the plurality of first HQMs comprises calculating a numerator representing a number of encounters in the first normalized patient data that satisfy selection criteria of a numerator portion of each of the first HQMs, and calculating a denominator representing a number of encounters in the first normalized patient data that satisfy selection criteria of a denominator portion of the first HQMs.

7. The method of claim 6, further comprising calculating each of the first HQMs as a ratio of the numerator to the denominator.

8. The method of claim 6, the step of deriving the plurality of first HQMs further comprises generating a plurality of lists containing encounter data entries obtained from the first normalized patient data where each of the entries represents an encounter that satisfies individual selection criterion of the selection criteria from at least one of the numerator portion and the denominator portion.

9. The method of claim 8, wherein the plurality of first HQMs is derived based on at least some of the plurality of lists.

10. The method of claim 6, wherein the denominator portion and the numerator portion are expressed as a non-SQL query.

11. The method of claim 6, further comprising the step of converting the denominator portion and the numerator portion into an SQL query.

12. The method of claim 6, further comprising the step of converting the denominator portion and the numerator portion into a postfix notation reverse polish algorithm.

13. The method of claim 1, wherein the step of defining the HQM expression includes providing a point and click elements of selection criteria within the organization interface to form the HQM expression.

14. The method of claim 1, wherein the step of generating the presentation package includes automatically formatting the first and second HQMs according to the organization'"'"'s requirements.