CodeX quality measures for cancer: Leveraging FHIR and mCODE to support digital quality measures.

Abstract

466 Background: CodeX is a member-driven Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR) Accelerator, building a community to fast-track interoperable data modeling and implementation of new FHIR data standards leading to step-change improvements in patient care and research. The Quality Measures for Cancer project asks the question, “Can oncology quality measures be effectively authored and executed using minimal Common Oncology Data Elements (mCODE) — an initiative intended to assemble a core set of structured data elements for oncology electronic health records (EHRs) — and FHIR, given that current measures must be manually collected and abstracted?” The Quality Measures for Cancer project aims to provide a less burdensome path for all parties involved in the quality measure lifecycle to share standardized oncology quality measure data. Methods: The Quality Measures for Cancer project has assembled a team of leading healthcare professionals from American Society of Clinical Oncology (ASCO), American Society for Radiation Oncology (ASTRO), Telligen, Evernorth, and MITRE to create a solution that demonstrates the ability to author and evaluate digital quality measures using FHIR standards, along with mCODE profiles and extensions, for value-based programs and clinical quality improvement in the oncology domain. More specifically, the initial project scope focuses efforts to: Develop a process for identifying the required discrete data to be used for data collection and aggregation; and prove that measures can be authored, generate accurate results, and can be executed using mCODE and FHIR. Results: Over the first year of project work, the Quality Measures for Cancer team has demonstrated that mCODE and FHIR can be used to author and execute oncology measures. The team has fully authored and tested two proof of concept ASCO antiemetic electronic clinical quality measures (eCQMs) using mCODE, FHIR, and the Quality Measures Implementation Guide. A demonstration is available to show the team's recent success with testing the feasibility and value of authoring and executing the two ASCO antiemetic eCQMs using mCODE and FHIR, evaluating the measure, and discussing how burden is reduced for providers, as well as submitters and receivers of quality measures. Conclusions: Long-term, the CodeX Quality Measures for Cancer team posits that by leveraging mCODE and FHIR to assist in the development and authoring of innovative oncology quality measures, real and impactful insight and assessment into true quality measures could be made if mCODE and other FHIR Implementation Guides are implemented and leveraged by an ecosystem of health organizations. This project is acting as an exemplar showing what can be achieved by leveraging several quality-specific FHIR Implementation Guides to create and roll out new, innovative quality measures.