Abstract

Objective

To explore the use of health plan quality measures specified for electronic clinical data to monitor immunizations.

Materials and Methods

We analyzed 2018 data submitted by health plans reporting 2 new Healthcare Effectiveness Data and Information Set measures assessing receipt of clinically recommended vaccines among pregnant women and adults. We analyzed the number of plans reporting a valid performance rate and electronic data source used. We consulted expert panels and reviewed coverage rates from other sources to understand the results.

Results

We received 136 data submissions across commercial, Medicaid and Medicare plans and 87 submissions across commercial and Medicaid plans for the adult and prenatal immunization measures, respectively. These submissions represent approximately 15% of possible submissions. Plans used claims, registries and electronic health records. Mean performance rates for adult immunizations were 21.2 (commercial), 14.0 (Medicaid) and 19.5% (Medicare). Mean rates for prenatal immunizations were 33.1 (commercial) and 16.7% (Medicaid).

Discussion

Results from the first year of reporting 2 electronic clinical data measures suggest health plans can feasibly report these measures and are seeking electronic data to supplement claims. Comparison of rates to other national results showed lower than expected rates for the adult immunization measure. However, prenatal immunization rates were on par with those from a national survey, suggesting this measure is closer to use for quality improvement.

Conclusion

Quality measure reporting that encourages connection to electronic data sources is a step forward in performance monitoring and improvement. The use of electronic sources may advance health information exchange for patient care.

中文翻译：

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利用电子临床数据报告成人和产前免疫质量措施

摘要

客观的

探索使用为电子临床数据指定的健康计划质量措施来监测免疫接种。

材料和方法

我们分析了健康计划提交的 2018 年数据，这些数据报告了 2 项新的医疗保健有效性数据和信息集措施，以评估孕妇和成人对临床推荐疫苗的接受情况。我们分析了报告有效绩效率和使用的电子数据源的计划数量。我们咨询了专家小组并审查了其他来源的覆盖率以了解结果。

结果

我们分别收到了商业、医疗补助和医疗保险计划的 136 份数据提交，以及成人和产前免疫措施的商业和医疗补助计划的 87 份数据提交。这些提交约占可能提交的 15%。计划使用了索赔、登记和电子健康记录。成人免疫接种的平均执行率为 21.2（商业）、14.0（医疗补助）和 19.5%（医疗保险）。产前免疫接种的平均比率为 33.1（商业）和 16.7%（医疗补助）。

讨论

报告 2 项电子临床数据措施的第一年的结果表明，健康计划可以切实报告这些措施，并正在寻求电子数据来补充索赔。与其他国家结果的比率比较显示成人免疫措施的比率低于预期。然而，产前免疫接种率与全国调查的结果持平，表明该措施更接近于用于提高质量。

结论

鼓励连接到电子数据源的质量度量报告是性能监控和改进的一个进步。电子资源的使用可以促进患者护理的健康信息交换。