(c) 2006, 2010 Brian Altonen

Balancing your Evaluations with HP 2010 and other tools used to define New Indicators.  Further Support for Indicators

Each of the two methods described so far for defining potential measures has relied upon two very different information sourcs.  The HEDIS-method for defining population health measures relies upon well established and heavily tested methods for reviewing health related performance and outcomes.  The method by which education programs are evaulated in order to define the current “hot topics” in medicine, relies mostly upon the popular culture of the health profession in the eyes of participants of these programs.  The first method presents outcomes for a fairly conservative approach to analyzing health related issues.  The second method relies on popular opinion, and the opinion of the program planners and financial supporters.

To bridge the significant differences between these two very different approached to defining reliable measures, we need to review what other methods exist for defining measurable population health features in other professional settings.  The following are these methods which can be used to form links between HEDIS and non-HEDIS methods so far proposed:

  • The development of National Clearinghouse Policy Guidelines supported measures
  • The development of potential measures supported by governmentally sponsored public health and health education programs, i.e. Healthy People 2010 supported and recommended, or recommendation by some commonly cited professional groups such as CDC, NIH, AAFP, or ACOG.
  • The development of measures supported by npo and other institutional recommendations or guidelines, for which adequate supporting documentation can be found and cited in refereed professional journals sources
  • The development of measures that meet some sort of well-recognized common sense sort of criteria, for which no guideline or policy exists due to the common sense nature of this activity, such as the measurement of group or percent participation in some form of preventive activity that has a measureable and quantifiable outcome (i.e. home glucose monitoring rates, for which no policies are usually produced, but to which some sort of regular screening is expected and can be numerically documented or evaluated based on claims and rx lists).

A review of the major sources for these forms of recommendation resulted in still further substantiation of conservative HEDIS measures and considerable support for many of the non-HEDIS measurements under review.   The general rules for this review is the most supporting documentation that can be found out there for a measurable indicator, the more trustworthy and reliable that indicator may become.  Ideally, for non-HEDIS indicators, we want multiple documentation in the form of either direct support for the measurement being performed, or indirect support in the form of related claims made regarding the measurement in question, or very similar health related aspects somehow directly linked to such a measure.

The following sections briefly define the findings of these reviews of supporting documentation for a number of heavily supported non-HEDIS measures.

  • Healthy People 2010 recommendations
  • National Clearing House Policies and Guidelines