Quality Matters: A Podcast by NCQA

On this episode of Quality Matters, we explore the growing importance of Health Information Exchanges (HIEs) and Qualified Health Information Networks (QHINs) with Laura McCrary, President and CEO of KONZA National Network. Laura discusses the pivotal role these systems play in quality care, enabling the secure and efficient sharing of medical records across diverse networks. By advancing the digitalization and interoperability of health data, these networks enhance patient safety and care coordination.

We explore how integrating claims data with clinical data enhances quality, underscoring the critical importance of trusted networks for data exchange. Laura dispels common myths surrounding HIEs and QHINs, while offering practical tips for health care organizations curious about connecting to these essential systems.

Additionally, we examine national efforts to expand connectivity and ensure that all health care organizations are part of a growing, robust data infrastructure. This episode serves as a handy guide for how to leverage HIEs and QHINs to participate in more capable and coordinated health care ecosystem.

Key Quote: 

“There is a lot more information available. It really is both a blessing and a curse. In the past, there was no information available for the doctor. Now there's so much. The first problem was how did we actually move the data from Florida, say, to New York? It's been solved through QHINs. As we solve one problem, we've created a new one, which is there's too much information available. We've got to address this new problem.”

-Laura McCrary, Ed.D

Time Stamps:

• (01:48) Challenges and Change in Data Exchange
• (03:48) Myths and Realities of HIEs and QHINs
• (07:35) Connecting Different Kinds of Data
• (10:27) Dimensions of Trust
• (14:29) Reducing Burden with Digital Measurement
• (16:06) Future of HIEs and QHINs

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Links:

NCQA resources on digital quality

Learn about KONZA

Connect with Laura

In this episode of Quality Matters, host Andy Reynolds delves into the transformative impact of the Trusted Exchange Framework and Common Agreement (TEFCA) on health care data interoperability. Joined by Amol Vyas, NCQA Vice President of Interoperability, and Eric Musser, Vice President of Federal Affairs, the discussion uncovers how TEFCA is reshaping the landscape of health information exchange.

Amol explains TEFCA’s function as a voluntary, national network (analogous to the postal service in its role as a connector) and highlighting implications for the free flow of HEDIS data. Eric provides insight into TEFCA’s bipartisan roots in the Cures Act of 2016, emphasizing TEFCA as a model of public-private partnership and standards-based improvement. 

Key Quote: 

“I think TEFCA has kind of been the underdog in health policy for a while now. Value-based care, patient safety, whole-person care, all those things are really salient topics that are brought up a lot. I think TEFCA is about to have its moment and I'm excited to see it come to greater fruition. I'm really happy to see all the progress we've made. It's going to take a full government, full industry approach to make this work for people. I think we're well on our way,”

-Eric Musser

Time Stamps:

(00:28) Understanding TEFCA

(01:42) New SOPs and Their Impact

(06:36) Public Policy Perspective on TEFCA

(10:00) Public-Private Partnership in TEFCA

(12:10) Looking Ahead with TEFCA

Links:
Bulk FHIR Quality Coalition

Digital Hub

Connect with Amol

Connect with Eric

In this episode of Quality Matters, host Andy Reynolds sits down with Rebecca Jacobson, CEO of Astrata, to explore the challenges and opportunities in transitioning to digital quality measurement in health care.

Rebecca offers an in-depth look at the sociotechnical shifts required for this evolution, sharing practical strategies to help organizations navigate this complex process. Discover how to overcome common obstacles, and learn about the real financial benefits that can convince even the most skeptical CFOs to invest in this transition.

Rebecca also provides a candid assessment of the industry's current state of readiness, emphasizing the importance of starting early for long-term success. She discusses why progress has been slower than expected and shares her updated timeline for widespread adoption.

Key Quote: 

“I'd want my billboard to say: “Digital quality, you can do it.”  Big things like this, big transformations that impact so much of the organization, they can be daunting, but we've seen plans make substantial progress that are clearly going to do very well. It can be done. Every quality team has it in them to guide this transformation and derive benefit. Just start now and have the confidence that you're able to do it, that there are a lot of resources that help you.”

-Dr. Rebecca Jacobson

Time Stamps:

(00:00) Introduction to Digital Quality Measurement

(01:03) Understanding the Industry's Readiness for Digital Transformation

(02:17) Challenges and Benefits of Digital Transition

(09:53) The Role of AI and Machine Learning

(14:55) Current Progress and Future Directions

Links:

Connect with Rebecca

Learn more about Astrata

Join the NCQA Industry Council

Explore the NCQA Digital Quality Hub

In this episode of Quality Matters, host Andy Reynolds discusses the U.S. Playbook to Address Social Determinants of Health with its lead author, Dr. Sandra Elizabeth Ford. Dr. Ford, a pediatrician and public health advocate with extensive experience at both local and federal levels, highlights the necessity of looking beyond clinical care to factors like housing, nutrition, and transportation. She emphasizes the importance of expanding data gathering and sharing, supporting flexible funding, and investing in backbone organizations to improve healthcare outcomes.

Dr. Ford also tackles the disconnect between local and national levels, advocating for leveraging local expertise and strengthening local programs before seeking federal support. The episode concludes with practical insights on integrating social needs into healthcare delivery and the importance of addressing these determinants to foster a sustainable healthcare system. Dr. Ford dives into what makes a successful organization in public health, focusing on the critical role of data. From the challenges of data standardization and sharing to the importance of good governance and leadership, this episode offers invaluable insights. This conversation is a must-listen for anyone passionate about creating a comprehensive healthcare system that truly considers the full spectrum of social determinants of health.

Key Quote: 

“We are not going to doctor ourselves out of the healthcare crisis. If we really want to address healthcare crises in this nation, we need to understand how are people living, what they're missing. We need to ask questions around how people live their lives. It’s cheaper to give somebody a food prescription than it is to treat an amputee from diabetes. So if we ask the questions on the front end of what people need, we’re better able to serve them from a clinical perspective.”

-Dr. Sandra Elizabeth Ford

Time Stamps:

(00:51) The Necessity of the Playbook

(02:48) Expanding Data Gathering and Sharing

(10:32) Challenges and Solutions in Data Management

(15:55) Common Misconceptions in Healthcare

Links:

Learn more about the Playbook

Connect with Dr. Sandra Elizabeth Ford

On this episode of “Quality Matters” with host Andy Reynolds, we explore the vital role of Sexual Orientation and Gender Identity (SOGI) data in healthcare. Our expert guests, Kellan Baker, Executive Director of the Whitman-Walker Institute, and Dr. Carl Streed, a primary care physician at Boston University, share why SOGI data are essential for delivering personalized health care interventions and improving overall health outcomes. Understanding sexual orientation and gender identity alongside other demographic variables like race and ethnicity is crucial for providing comprehensive and inclusive care. Emphasizing the importance of building trust within healthcare settings, our guests discuss how fostering a trustworthy environment encourages the sharing of sensitive SOGI information, which is vital for patient care quality.

The conversation addresses the challenges the current political climate poses and its potential negative impacts on LGBTQ health. We highlight the necessity of robust privacy protections to prevent the misuse of SOGI data and the role of the entire healthcare team in safeguarding this information. Additionally, we share insights into new resources from the US Department of Health and Human Services to enhance demographic data quality. Calvin emphasizes recognizing LGBTQ individuals as people with unique stories and the importance of methodological data collection. For further guidance, recommendations include resources from the Office of the Assistant Secretary for Planning and Evaluation at the US Department of Health and Human Services. 

Key Quote: 

“These are intimate areas of people's lives that we're dealing with in health care, and HIPAA was enacted to protect that information from exploitation and misuse. so it's incredibly sad to see state actors intentionally misusing the law. To take personal health information from patients, from families, from healthcare institutions, not just that incredible intrusion into the provider patient relationship, but then also to Press charges against healthcare providers, for providing medical care in accordance with their training and expertise. It's an incredible violation of HIPAA and something that should concern all of us, regardless of whether we're transgender or we provide care to transgender people.”

-Kellan Baker, Executive Director of the Whitman-Walker Institute

Time Stamps:

(00:44) Understanding SOGI Data

(03:26) Challenges and Misconceptions about SOGI Data

(05:51) Legal Issues and Misuse of SOGI Data

(11:01) Finding Trust in Healthcare Systems

(13:12) The  Future of SOGI Data Collection

Links:

Connect with Kellan Baker

Connect with Dr. Carl Streed

Learn more about the Whiteman-Walker Institute 

Learn more about the GenderCare Center at Boston University School of Medicine

In the first episode of a two-part series titled, 'In Data We Trust,' host Andy Reynolds and Tam Ward, Senior Vice President of Business Strategy and Operations at Oscar Health,  discuss the intersection of technology and health care to improve care equity, especially in underserved communities. 

Focusing on initiatives by Oscar Health, Tam highlights efforts to build culturally competent care networks and improve data-driven solutions for marginalized groups, including African Americans and the LGBTQ community. 

The episode emphasizes the importance of trust, transparent data sharing, and personalization in healthcare to address disparities and enhance patient experiences.

Key Quote: 

“If there was one ask I could have of those in a place of influence to help create standardization around provider data, it's share the attributes of the physician that are important to the patient and hold us accountable for doing what's right with that information.”

-Tam Ward

Time Stamps:

(02:32) Oscar's Approach to Culturally Competent Care

(04:57) Challenges and Solutions in Provider Data

(08:46) Building Trust in Healthcare

(10:58) Focus on LGBTQ+ Community

Links:

Connect with Tam 

Visit Oscar Health

Join us for an insightful conversation with North Carolina Secretary of Health and Human Services, Kody Kinsley, as he shares how growing up without health insurance influences his drive to improve health care access and affordability in his home state. Discover the transformative impact of the state’s recent Medicaid expansion and substantial investments in behavioral health.

Secretary Kinsley emphasizes North Carolina’s novel, bipartisan approach to improving care. The discussion covers innovative strategies for staffing the 988 crisis hotline and the unusual integration of the health care system and the prison system. Secretary Kinsley ends with reflections on leadership in an era of identity politics and his advice for quality advocates everywhere. 

Key Quote: 

“We are very excited to have, after 10 years been able to finally expand Medicaid. And not only have we gotten it done, we've gotten it done well.  The other thing that's particularly exciting was a near billion-dollar investment in behavioral health. That is just so consequential to overall health and well-being, something that had also been forgotten and neglected for too long,”

-Secretary of the North Carolina Department of Health and Human Services Kody Kinsley

Time Stamps:

(01:48) Medicaid Expansion: A New Era

(05:11) Bipartisanship and Community Engagement

(06:37) Challenges and Solutions in Behavioral Health

(11:56) Innovative Approaches to Health Care and Justice

(13:23) Social Determinants of Health: A Holistic Approach

(21:09) Taking Pride in One’s Holistic Identity and Quality Gains

Links:

Learn more about Secretary Kinsley

University of Chicago professor and Doctor, Marshall Chin, joins us on Quality Matters to revolutionize medical training with his unique blend of improv and stand-up comedy. Discover how these innovative techniques equip medical students with the skills to care for diverse patients and engage in vital discussions about systemic racism and social privilege. By prioritizing active listening and real-time interaction, Dr. Chin's approach helps shift the perspective from merely addressing health disparities to fostering genuine health equity.

The episode culminates with actionable strategies to propel health equity forward, highlighting the importance of culturally tailored solutions and comprehensive interventions. We explore the power of honest dialogues about racism, power, and privilege, and discuss how lifelong learning and diverse experiences, akin to team sports, can drive systemic change. 

Join us for this enlightening conversation that underscores the critical need for continuous improvement and authentic community partnerships to pursue health equity.

Key Quote: 

“The thing about health equity is that it’s the right thing. Everyone wants to do the right thing. And it requires all this expertise and all these stakeholders. It has the community expertise. It requires the clinicians on the staff who have the frontline experience. It requires people who do quality improvement. It includes the data people. I mean, everyone has a role.” - Dr. Marshall Chin

Time Stamps:

(00:00) Achieving Health Equity Through Innovation

(05:55) Equity and Intersectionality in Healthcare

(14:28) Advancing Health EquityThrough Lifelong Learning

Links:

Resources Marshall Chin recommends in the episode include:

Health Care Payment Learning & Action Network.

Achieving Health Equity tools from The Robert Wood John Foundation

What Should Antiracist Payment Reform Look Like?

Cruelty and Health Inequity (abstract)

The book The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together , by Heather McGhee, and discussed here

 Welcome to "Quality Matters," the podcast where we unpack the complexities of modern healthcare to shape a brighter future. Join us as we delve into the dynamic world of healthcare quality and innovation, exploring topics such as digital transformation, health equity, and quality standards.

Each episode brings together thought leaders, industry experts, and innovators to discuss the latest trends, best practices, and challenges shaping the future of healthcare. With a focus on convening voices from across the industry, "Quality Matters" provides a platform for meaningful conversations and collaboration.

Whether you're a health plan leader, a health IT professional, or simply someone passionate about improving healthcare outcomes, tune in to gain valuable insights and actionable strategies for driving positive change in healthcare delivery.

Because when it comes to healthcare, quality truly matters. Join us on "Quality Matters" as we shape tomorrow's healthcare today.

In this episode, we highlight two companies that leverage data from many different sources to create a more complete picture of a person’s health. The ultimate goal? Shifting away from the current model of “sick care” - where patients primarily see their doctors when they aren’t feeling well – to care models that prioritize long-term health and self-management with guidance from providers. These companies are helping lead the way to value-based care, from using AI to sift through patient-reported data and provide actionable insights, to integrating NCQA's HEDIS measurements into their data platform, thereby putting quality at the center of everything they do. Here, you’ll get a glimpse into the challenges and opportunities in our current data-rich health care ecosystem.

The episode begins with a conversation with leaders from Welldoc. Welldoc is a health tech company developing patient-facing apps to support self-management of chronic conditions. Using an omnichannel approach, their apps gather as much data as possible from sources including remote monitoring devices, like wearables, and clinical data.

Chief Analytics Officer, Dr. Anand Iyer, and Chief Medical Officer, Dr. Mansur Shomali, explain how Welldoc uses AI to parse the patient information, ultimately helping doctors and patients work together to construct an effective path to wellness.

Jessica Robinson is Chief Platform Officer for health care digital developer The Garage. Jessica manages all aspects of the product life cycle, from the spark of innovation through design, development, testing, and roll-out. Founded in 2012, The Garage aims to utilize digital tools to help providers shift from fee for service models to value-based models of care.

In this interview, recorded live at NCQA’s 2023 Health Innovation Summit, Jessica explains how The Garage works with Management Service and Accountable Care organizations, among other provider groups, to develop digital applications that help clinically integrated networks across 34 states harness the full extent of the population data available to them. The Garage also utilize NCQA’s HEDIS measures into their platform, allowing networks to visualize the full patient care team across the entire care continuum and deliver optimized quality care to their patients.

For information on NCQA’s Health Equity Forum, click here: https://events.ncqa.org/healthequityforum