ToC+-+Success+Metrics+Meeting+Minutes+08-09-2011

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Agenda/Objectives:

 * **Topic** || **Owner** || **Time Allotted** ||
 * Continue to walk through the feasibility of success metrics
 * How and from where to get the data? || Dr. Leftwich || 3:00-3:30 ||
 * Timeframe for the success metrics
 * 2011-2014 (inclusive) || Dr. Leftwich || 3:30-3:50 ||
 * Wrap up/Next Steps || Dr. Leftwich and Smriti/Brandy || 3:50-4:00 ||
 * Adjourn ||  || 4:00 ||

Attendees:
H Stevens, Sandy Stuart, Andriy Selivonenko, Mayuri Patel, Laura Heermann, Russell Leftwich MD, Susan Campbell, Brandy Hays, Allen Hobbs, Susan Nedza, Brandy Hays, Smriti Singal

Action Items:

 * **Action Item** || **Next Steps / Status** || **Lead** || **Contributors** || **Due Date** ||
 * Ask ONC if they are expecting Numbers or percentages || In Progress || Support Team || n/a || ASAP ||
 * Define small, medium, and large Clinical Organizations || In Progress || Susan Nezda || n/a || 8/16/11 ||
 * Map the metrics back to MU criteria to see which ones apply to transitions of care || In Progress || Support Team || Success Metrics Workgroup || 8/23/11 ||
 * Ask ONC what is mandatory and what is “nice to have” || In Progress || Support Team || n/a || ASAP ||

**ToC Success Metrics Category Discussion:**

 * PHRs may not be able to send data elements within the time frame of this project, therefore the matrix separates out EHRs and PHRs; however, PHRs can receive core data elements.
 * There were some concerns about stakeholders having to constantly report metrics and calculate them. More clarity was given during the call around the time frame of this particular project.
 * In the coming weeks, this SWG will address both the numerator and denominator of each metric.
 * 90% of criteria for MU, require ToC exchange.
 * Many participants voiced concerns with trying to capture “Number” of exchanges (exactly how many exchanges took place) rather than a percentage. Currently, entities are required to report percentages and not exact numbers.
 * Group asked for clarification from ONC in terms of preference.
 * The workgroup members requested more clarification around the terms, large, medium, and small in terms of Clinical Organizations.
 * Prior to vendors becoming Stage 2, they will not have the appropriate data to address some of the metrics.
 * There are other organizations that collected concrete numbers, and then calculated percentages for reporting purposes. We should also report the numerator and denominator along with the percentage.
 * Some of the participants had concerns that the metrics have gotten to be too granular. We begin to lose the value of the data the more granular they become. Also, it becomes expensive to collect the data to support the metrics. It becomes difficult to capture whether or not the quality of care for a patient was better this year than from last year.
 * Patient communication preference is not a function of the data exchange. The group decided to remove this metric.
 * We don’t know if this data is easily available. May be held by the HIEs.
 * The Lab Results Interface Initiative leveraged informational interviews to gather data that was not easily found through research.
 * Clinical Quality (Preventing Adverse Events) is not feasible. Need to define an “event”.
 * Cost & Efficiency (Reduction of Admissions/Re-admissions) – efficiency isn't defined, cost is defined by claims data; hospital won’t have data across multiple hospital admissions. Calculated by Medicare, not by the hospitals. Hospitals report re-admission rates.

**Resolutions:**

 * Support team will ask ONC preference for percent versus number.
 * Map Metrics to the Stages of MU (support team will look into organizing this effort)
 * Support team will ask ONC which metrics are mandatory and which are nice to have.
 * The group will research whether or not there are other Federal agencies that use metrics like the ones we have come up with.
 * Dr. Nedza volunteered to help define “small, medium, large” in terms of Clinical Organizations
 * The group decided to remove Patient communication preference as a metric.

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