title: Using health information exchanges to calculate clinical quality measures: A study of barriers and facilitators.
abstract: BACKGROUND
  A key motivation for the large national investment in electronic health record systems is to promote electronic reporting of quality measures that can be used as the basis for moving to value-based payment. Given the fragmented delivery system, robust quality reporting requires aggregating data across sites of care. Health information exchanges (HIEs) have emerged to facilitate exchange of clinical data across provider organizations and, therefore, should be well-positioned to support clinical quality measure reporting.
  
  
  METHODS
  By interviewing representatives from 36 HIEs across the United States, we aimed to determine whether HIEs are capable of computing National Quality Forum measures for 6 cardiovascular disease preventive services.
  
  
  RESULTS
  Eleven HIEs (30%) reported computing at least one CQM; six computed one or more of the measures, and no HIE computed a measure in each of the 6 areas. Barriers to computing CQMs included data quality, completeness, sharing, and transmission issues; organizational structure, maturity, and sustainability issues; and vendor issues.
  
  
  CONCLUSIONS
  The ability to compute CQMs at the HIE level is still yet to be developed; currently, very few HIEs are able to do so for a variety of reasons. As HIE services expand and HIEs mature organizationally, the viability and utility of CQM reporting at the HIE level will increase.
  
  
  CONCLUSIONS
  As the healthcare system migrates towards a value-based payment system these broad challenges will need to be addressed.
  
  
  METHODS
  Cross-sectional semi-structured qualitative interviews.
authors.affiliation: Center for the Advancement of Health Information Technology, RTI International, United States.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Massoudi
authors.affiliation: Center for the Advancement of Health Information Technology, RTI International, United States.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Marcial
authors.affiliation: Health Care Quality Program, RTI International, United States.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tant
authors.affiliation: School of Information and School of Public Health, University of Michigan, United States.
authors.forename: Julia
authors.initials: J
authors.lastname: Adler-Milstein
authors.affiliation: Health Care Quality Program, RTI International, United States.
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: West
mesh_terms: D003430:Cross-Sectional Studies; D066275:Health Information Exchange / Q000706:statistics & numerical data*; D063005:Health Information Systems / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D014481:United States