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Acknowledgments
Thank you to:
The National Highway Traffic Safety
Administration for funding and supporting
this important...
History of EMS Data &
Quality Systems
2009 NHTSA – EMS
Performance Measures
Based on V2.2
1997 NHTSA - A
Leadership Guide ...
NEMSIS Datasets Supporting
Performance Measurement
What can you do
with your data?
NEMSIS = National EMS Information Syste...
Patient
Centered
Health
Systems
The Patient
SmarterSpending
Triple Aim
Medicare (CMS) Payment System Categories
1. FFS with no link of
payment to quality
2. FFS with a link of
payment to qualit...
Pay For Performance is here!
Value: CMS fee for service based payments tied to
value for providers in alternative payment ...
Health Care Learning & Action
Network
The Department of Health & Human
Services is facilitating public-private
partnership...
CMS Quality Measures
1. Developed by Measure Stewards (such as
NASEMSO)
2. Submitted to National Quality Forum (NQF)
3. Ex...
EMS Performance Measures
EMS industry opportunity to develop
measures from us and work for us!
EMS Compass Initiative will...
Measure Conceptualization
Public Call
For
Measures
Webinars for
Public Input
Prioritization
Measure Specification
Evidence
Review
Measure
Drafting
Evidence
Review
Technical
Specification
Feasibility
Evaluation
Measure Testing
Alpha
Testing
Beta – Public
Testing &
Input
Revisions
Measure Implementation
Measure
Approval
eCQM
Documentation
NQF Submission
CMS eCQM
Submission
What is a performance measure?
Measurement Domain
Clinical
Area
Topic
Family of Measures
Structure
Process
Outcome
Balanci...
Call For
Measures
Public & Expert
Input
Prioritization
Evidence
Review
Measure
Design
Measure Testing
•Vendor technical te...
EMS Compass Domains
Domains Example Possible Clinical Conditions & Topics
Patient and Family
Engagement
Customer satisfact...
EMS Measure Considerations
NQF Priority Criteria*
– Importance to Measure and Report
– Feasibility
– Scientific acceptabil...
Overall Org Chart
Steering Committee
(Bob Bass, MD)
Evidence Review
Group
(Alex Garza, MD)
Measure Design Group
(Dave Will...
EMS Compass Initiative Meetings
Steering Committee:
• 20 members 4 meetings
Evidence Review Group:
• 7-10 members +/-
Meas...
Initiative Activity Schedule
Oct. 2014: Project Started
Jan. 2015-July 2016: 24 meetings & workgroups
May 2015: Call For M...
During May 2015 the Call For Measures is open for submission
Go to: http://emscompass.org/call-for-measures/
Call For Meas...
EMS Compass Domains
Domains Example Possible Clinical Conditions & Topics
Patient and Family
Engagement
Customer satisfact...
Domain: Clinical
Process/Effectiveness
Metrics - Healthcare
Metrics
Metrics
Metrics
Clinical Process/Effectiveness
Clinical Process/Effectiveness
Clinical Process/Effectiveness
Clinical Process/Effectiveness
Domain: Clinical
Process/Effectiveness
Domain: Efficient Use of
Healthcare Resources
Domain: Efficient Use of
Healthcare Resources
Domain: Efficient Use of
Healthcare Resources
Domain: Efficient Use of
Healthcare Resources
Domain: Patient Safety
Domain: Patient Safety
Domain: Patient Safety
Domain: Patient Safety
Domain: Patient Safety
For more information please contact:
Nick Nudell
Project Manager – EMS Compass Initiative
nick@nasemso.org
(760) 405-6869
...
EMS Compass Overview Call For Measures May 2015
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EMS Compass Overview Call For Measures May 2015

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The EMS Compass Initiative opened a call for measures to be submitted during May 2015. This provides an overview of the project and how these performance measures will be designed by EMS and used by EMS providers. The measures will demonstrate the value of EMS care for a community and for patients.

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EMS Compass Overview Call For Measures May 2015

  1. 1. Acknowledgments Thank you to: The National Highway Traffic Safety Administration for funding and supporting this important work. 50 workgroup and committee members giving their time and expertise! Public volunteers who will test and discuss draft measures prior to becoming final.
  2. 2. History of EMS Data & Quality Systems 2009 NHTSA – EMS Performance Measures Based on V2.2 1997 NHTSA - A Leadership Guide to Quality Improvement
  3. 3. NEMSIS Datasets Supporting Performance Measurement What can you do with your data? NEMSIS = National EMS Information System Managed by the University of Utah’s Technical Assistance Center
  4. 4. Patient Centered Health Systems The Patient SmarterSpending Triple Aim
  5. 5. Medicare (CMS) Payment System Categories 1. FFS with no link of payment to quality 2. FFS with a link of payment to quality 3. Alternative payment models built on FFS architecture 4. Population-based payment Description Payment is based on volume, not quality A portion of payment vary based on quality or efficiency of health care delivery Some payment linked to effective management of a population or episode of care. Still triggered by delivery of services. Payment NOT directly linked to service delivery. Payment & responsibility for long term care of beneficiary (e.g. ≥ 1yr). CMSFFS • Limited in CMS FFS • Majority of CMS payments now linked to quality • Hospital value-based purchasing • Physician value-based modifier • Readmission/Hospital Acquired Condition Reduction Program • ACOs • Medical Homes • Bundled payments • Comprehensive primary care • Eligible Pioneer accountable care organizations in years 3-5 FFS= Fee For Service ACO= Accountable Care Organization
  6. 6. Pay For Performance is here! Value: CMS fee for service based payments tied to value for providers in alternative payment models (i.e. accountable care organizations, medical homes, bundled payments) 1. 30% by 2016 2. 50% by 2018 Quality: CMS quality program (performance measures) participation 1. 85% by 2016 2. 90% by 2018
  7. 7. Health Care Learning & Action Network The Department of Health & Human Services is facilitating public-private partnerships to meet or exceed the CMS goals for value based payments
  8. 8. CMS Quality Measures 1. Developed by Measure Stewards (such as NASEMSO) 2. Submitted to National Quality Forum (NQF) 3. Extensive public evaluation of draft measures 4. NQF chooses to endorse measure (or not) 5. CMS chooses to accept measure (or not) for payment 6. Health care providers submit Measure Scores electronically to CMS
  9. 9. EMS Performance Measures EMS industry opportunity to develop measures from us and work for us! EMS Compass Initiative will: 1. Develop a process for designing EMS specific performance measures. 2. Design a family of structural, outcome, process, and balancing measures. 3. Develop a guidance for EMS agencies and providers in how to use measures.
  10. 10. Measure Conceptualization Public Call For Measures Webinars for Public Input Prioritization
  11. 11. Measure Specification Evidence Review Measure Drafting Evidence Review Technical Specification Feasibility Evaluation
  12. 12. Measure Testing Alpha Testing Beta – Public Testing & Input Revisions
  13. 13. Measure Implementation Measure Approval eCQM Documentation NQF Submission CMS eCQM Submission
  14. 14. What is a performance measure? Measurement Domain Clinical Area Topic Family of Measures Structure Process Outcome Balancing Measure Formula Denominator Numerator =Score
  15. 15. Call For Measures Public & Expert Input Prioritization Evidence Review Measure Design Measure Testing •Vendor technical testing •Public testing & input Steering Committee Approval Submission to NQF & CMS Measure Design Process: A Continuous Cycle
  16. 16. EMS Compass Domains Domains Example Possible Clinical Conditions & Topics Patient and Family Engagement Customer satisfaction, parent/family involvement, patient experience Patient Safety Stretcher drop rate, adverse event rate, ambulance crash rate, deteriorating patient (early warning), infection control/hand hygiene Care Coordination Matching care to need, access Population/Public Health Volumes, symptoms onset to 911, requests per capita Efficient Use of Healthcare Resources Cost per capita/patient, tax dollars per capita, patient utilization rate, patient contact time reliability, crash scene time Clinical Process/Effectiveness Stroke, STEMI, SCA, trauma, RAD, sepsis, CHF, pain management, hypoglycemia, seizures, COPD, mental health, anaphylaxis , provider skill success rate EMS Workforce* Turnover/Retention, vacancy rate, productivity, Compensation Comparator, injury rate, lost work days rate, education, R&R, certification & licensure, safety (near miss reporting, policies, etc), provider safety EMS Fleet* Vehicle miles traveled (VMT) rates EMS Data* NEMSIS submission rate, data integrity EMS Finance* Reimbursement rates *EMS Convenience Domains that are outside the NQS/NQF original six but may prove to be necessary for EMS performance measurement.
  17. 17. EMS Measure Considerations NQF Priority Criteria* – Importance to Measure and Report – Feasibility – Scientific acceptability of measure properties** – Usability and Use – Comparison to related or Competing measures. Data source from the National Emergency Medical Services Information System (NEMSIS) Version 3 generation data whenever possible. * http://www.qualityforum.org/docs/measure_evaluation_criteria.aspx ** The preferred systems for grading the evidence are the U.S. Preventive Services Task Force (USPSTF) grading definitions and methods, or Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines.
  18. 18. Overall Org Chart Steering Committee (Bob Bass, MD) Evidence Review Group (Alex Garza, MD) Measure Design Group (Dave Williams, PhD) Technology Developers Group (Debbie Gilligan) Stakeholder Communication Group (Keith Griffiths, BA) Project Execution Group (Dia Gainor, MPA) Federal Partners Project Staff: Nick Nudell, MS, NRP – Project Manager Zoe Renfro, BA – Project Staff
  19. 19. EMS Compass Initiative Meetings Steering Committee: • 20 members 4 meetings Evidence Review Group: • 7-10 members +/- Measurement Design Group: • 12 members 8 meetings Technology Developers Group: • 9 members 2 meetings Communications Group: • 6 members 4 meetings
  20. 20. Initiative Activity Schedule Oct. 2014: Project Started Jan. 2015-July 2016: 24 meetings & workgroups May 2015: Call For Measures Open July 2016: Submit to peer review journal July-Aug. 2016: Conduct Blue Ribbon Panel Aug. 2016: Publish NASEMSO document Sept. 2016: Completion of this phase
  21. 21. During May 2015 the Call For Measures is open for submission Go to: http://emscompass.org/call-for-measures/ Call For Measures
  22. 22. EMS Compass Domains Domains Example Possible Clinical Conditions & Topics Patient and Family Engagement Customer satisfaction, parent/family involvement, patient experience Patient Safety Stretcher drop rate, adverse event rate, ambulance crash rate, deteriorating patient (early warning), infection control/hand hygiene Care Coordination Matching care to need, access Population/Public Health Volumes, symptoms onset to 911, requests per capita Efficient Use of Healthcare Resources Cost per capita/patient, tax dollars per capita, patient utilization rate, patient contact time reliability, crash scene time Clinical Process/Effectiveness Stroke, STEMI, SCA, trauma, RAD, sepsis, CHF, pain management, hypoglycemia, seizures, COPD, mental health, anaphylaxis , provider skill success rate EMS Workforce* Turnover/Retention, vacancy rate, productivity, Compensation Comparator, injury rate, lost work days rate, education, R&R, certification & licensure, safety (near miss reporting, policies, etc), provider safety EMS Fleet* Vehicle miles traveled (VMT) rates EMS Data* NEMSIS submission rate, data integrity EMS Finance* Reimbursement rates *EMS Convenience Domains that are outside the NQS/NQF original six but may prove to be necessary for EMS performance measurement.
  23. 23. Domain: Clinical Process/Effectiveness
  24. 24. Metrics - Healthcare
  25. 25. Metrics
  26. 26. Metrics
  27. 27. Metrics
  28. 28. Clinical Process/Effectiveness
  29. 29. Clinical Process/Effectiveness
  30. 30. Clinical Process/Effectiveness
  31. 31. Clinical Process/Effectiveness
  32. 32. Domain: Clinical Process/Effectiveness
  33. 33. Domain: Efficient Use of Healthcare Resources
  34. 34. Domain: Efficient Use of Healthcare Resources
  35. 35. Domain: Efficient Use of Healthcare Resources
  36. 36. Domain: Efficient Use of Healthcare Resources
  37. 37. Domain: Patient Safety
  38. 38. Domain: Patient Safety
  39. 39. Domain: Patient Safety
  40. 40. Domain: Patient Safety
  41. 41. Domain: Patient Safety
  42. 42. For more information please contact: Nick Nudell Project Manager – EMS Compass Initiative nick@nasemso.org (760) 405-6869 EMSCompass.org https://www.facebook.com/EMSCompass https://www.linkedin.com/company/ems-compass https://twitter.com/EMSCompass #EMSCompass

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