Robust quality measurement helps all parts of the health care system deliver safe, effective and more efficient care. That’s why OptumLabs is driving innovation in measures dedicated to improving health care quality.
Much of our effort in quality measure development is supported by funding from AARP Quality Measure Innovation Grants.
AARP Quality Measure Innovation Grant Program
Launched as a collaboration with AARP, OptumLabs, and the National Quality Forum (NQF) Measure Incubator® in 2016, the goal of the AARP measure innovation grant program is to encourage the use of data-driven evidence to spur improvements in the field of quality measurement.
This program convenes diverse project teams and stakeholders to foster novel measure development, innovate in measurement science and generate new insights on ways to fill important quality measure gaps using OptumLabs’ rich data set.
To date, seven grants focused on the health of those in the 50+ age group have been awarded over three funding cycles, with two new winners announced at the 2019 OptumLabs Research & Translation Forum in November.
Awardee: American Academy of Hospice & Palliative Medicine, University of California-San Francisco, Mt. Sinai, University of North Carolina–Chapel Hill
Award date: 2015 (Cycle 1)
The goal of this project was to identify a way to define “serious illness” using administrative data from claims and clinical data from electronic health records (EHRs) to help improve pain management strategies and access to palliative care for the right individuals.OR
Awardee: Mayo Clinic
Awarded: 2015 (Cycle 1)
Current HbA1c control measures don’t adjust for patient complexity, including comorbidity burden and age, and medication burden. As a result, these measures can lead to overtreatment for some patients and undertreatment for others. Both these situations can lead to patient harm — hypoglycemia for those overtreated and hyperglycemia and significant long-term complications for those who are undertreated. The team sought to define an approach to glucose therapy management that balanced the risks and benefits associated with oral medications and insulin treatment, looking carefully at clinical complexity and treatment intensity.OR
Awardee: Pharmacy Quality Alliance (PQA), University of Maryland, School of Pharmacy
Awarded: 2015 and 2017 (Cycles 1 and 2)
The team has worked to quantify 1) bleeding events associated with anticoagulants and 2) hypoglycemic events associated with antihyperglycemics. These two areas were called out as key priorities in HHS’ Office of Disease Prevention and Health Promotion’s National Action Plan for Adverse Drug Event (ADE) Prevention, which seeks to reduce patient harm in areas where ADEs are common, clinically significant, preventable and measurable. The team is continuing with further development and testing to determine their relevance for health plans and accountable care organizations (ACOs).OR
Awardee: Tufts Medical Center
Award date: 2017 (Cycle 2)
This project seeks to create and test an automated, electronic “trigger” tool for identifying treatment related injuries among breast, colorectal, lung and prostate cancer patients across the continuum of care. Triggers, such as certain abnormal laboratory test values or the use of antidote medications, are clinical indicators that suggest the possibility of an adverse event. By measuring the relationships between such triggers and common outcome measures of quality, including mortality, readmissions and health care resource utilization, the team hopes to work toward the goal of shared decision-making between patients and clinicians pursuant to the right therapy, for the right person, at the right time.OR
Awardee: National Kidney Foundation
Award date: 2019 (Cycle 3)
The National Kidney Foundation, in collaboration with American Medical Group Association (AMGA), National Committee for Quality Assurance (NCQA), Physician Consortium for Performance Improvement (PCPI) and the University of California, San Francisco, proposed a performance measure to evaluate kidney health in adults with diabetes. They propose to measure levels of kidney function and damage for patients with diabetes to assist with early detection, monitoring and prediction of patient risk levels for chronic kidney disease (CKD).
This is an important measure to improve care for older adults who broadly have a high prevalence of diabetes and furthermore have substantially undiagnosed or poorly monitored CKD.OR
Awardee: Johns Hopkins Armstrong Institute for Patient Safety and Quality
Award date: 2019 (Cycle 3)
Johns Hopkins Armstrong Institute for Patient Safety and Quality proposed to measure stroke misdiagnosis in hospital emergency rooms. The measure is based on Symptom-Disease Pair Analysis of Diagnostic Error (SPADE), a framework and methodological approach for uncovering misdiagnosis-related harms using “big data.”
This measure focuses on patients who experience a poor outcome (e.g., a stroke) when their symptoms are not correctly diagnosed at an emergency room visit. The correct diagnosis of stroke is vitally important as it is among the top five leading causes of death and the leading cause of serious, long-term disability in the U.S. Measuring stroke misdiagnosis is especially important for older patients because 75% of all strokes occur in patients over age 65 and misdiagnosis of stroke results in substantial harm for all ages.OR
Making an impact
The AARP sponsored quality measurement work is designed to translate to the development of meaningful performance measures that will eventually fill important quality gaps, support accountability in value-based care models and improve the lives of older Americans.
A few of these projects are already poised to make an impact on care:
- Results of the Tufts Medical Center project were recently published in Cancer Medicine. Ultimately, Weingart and his team hope the work can be extended to integrate cancer-specific trigger tools into the electronic health record, allowing clinicians to identify and address treatment-related adverse events in real time.
- Mayo Clinic has developed a quality measure for appropriate diabetes management to help doctors recognize patient complexity and find the “sweet spot” for each patient circumstance; considering the benefits and harms of each medication, and aiming for “better,” not always “lower,” blood sugar levels.
We are helping to create measures that matter — not just to scientists and researchers, but to everyone involved in health care.