Examining the Specification Validity of the HEDIS Quality Measures for Substance Use Disorders.
Accurate operationalization is a major challenge in developing quality measures for substance use disorder treatment. Specification validity is a term used to describe whether a quality measure is operationalized such that it captures the intended care processes and patients. This study assessed the specification validity of the 2009 Healthcare Effectiveness Data and Information Set (HEDIS®) substance use disorder initiation and engagement measures by examining whether encounters assumed to include relevant treatment have corroborating evidence in the clinical progress notes. The positive predictive values were excellent (>90%) for residential and outpatient records selected from addiction treatment programs but more modest for records generated in non-addiction settings, and were highly variable across facilities. Stakeholders using these measures to compare care quality should be mindful of the clinical composition of the data and determine if similar validation work has been conducted on the systems being evaluated.
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Alexander.Harris2@va.gov.
Alex H S
AH
Harris
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Laura.Ellerbe@va.gov.
Laura
L
Ellerbe
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Tyler.Phelps@va.gov.
Tyler E
TE
Phelps
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: John.Finney@va.gov.
John W
JW
Finney
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Thomas.Bowe@va.gov.
Thomas
T
Bowe
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Shalini.Gupta2@va.gov.
Shalini
S
Gupta
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Steven.Asch@va.gov.
Steven M
SM
Asch
Center for Innovation to Implementation, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: knh@stanford.edu.
Keith
K
Humphreys
Program Evaluation and Resource Center, VA Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD152), Menlo Park, CA 94025. Electronic address: Jodie.Trafton@va.gov.
Jodie
J
Trafton
D002140:California; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D006801:Humans; D008499:Medical Records; D011237:Predictive Value of Tests; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000628:therapy
Electronic medical records; Quality measurement; Specification validity; Substance-related disorders; Veterans Health Administration