Improving Clinical Quality of HCV Care Using Health Information Technology

 

In 2013 and 2014, CDC, AASLD, and the American Gastroenterological Association Institute participated in a multi-stakeholder process with the American Medical Association’s (AMA) Physician Consortium for Performance Improvement® (PCPI®) to develop and update quality performance measures for HCV. These measures support delivery of care in the Institute of Medicine’s six aims for quality improvement (i.e., safe, effective, patient-centered, timely, efficient, and equitable). The final updated Hepatitis C Performance Measurement Set approved by the AMA consists of 14 measures, including measures on timely care and outcomes (i.e., sustained virologic response).

CDC also partnered with the Office of the National Coordination for Health Information Technology (ONC) to develop electronic clinical quality measures (eCQM) and clinical decision support (CDS) tools for incorporation in to electronic health records for three of the quality measures:

  • 8a: Screening for HCV for Patients at High Risk (i.e., injection drug use, blood transfusions prior to 1992, hemodialysis, or birth during 1945–1965); 
  • 8b: Annual HCV Screening for Patients who are Active Injection Drug Users; and
  • 8c: Referral to Treatment for Patients Identified with HCV Infection. 

This work leverages the ONC and the HHS Health e-Decisions Standards and Interoperability Framework project to facilitate scalable distribution of corresponding decision support artifacts, allowing any care provider to easily incorporate best practices into their workflow. Electronic specification of clinical quality measures related to HCV screening will eventually support inclusion in the Centers for Medicare and Medicaid Services (CMS) meaningful use incentive program for providers and hospitals. The meaningful use incentive program may promote the use of these measures, and when coupled with CDS tools, could result in broader implementation of CDC’s HCV testing recommendations.

In 2015, CDC will collaborate with AMA to conduct field and validity testing, in order to prepare these three measures for submission to the National Quality Forum for endorsement. The ultimate goal is the adoption of these measures by CMS and implementation of the eCQM and CDS tools by providers.

This project is funded by Gilead Sciences.