Current quality measurement processes are labor-intensive, involving manual chart reviews and use of paper-based quality measures that vary in format and definitions from measure to measure. Automated quality reporting is considered by many to be an important tool that will help close the gaps in the quality of US health by increasing the timeliness, effectiveness, and use of quality assessment. In 2007, the US Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC) funded three Nationwide Health Information Network (NHIN) health information exchanges (HIE) to demonstrate the feasibility of automated quality reporting by using existing or emerging standards to aggregate information from multiple providers, transmit patient-level quality data in standardized formats, perform an automated quality assessment, and generate a quality report document for electronic transmission. Long Beach Network for Health (LBNH), a NHIN Cooperative HIE, developed a web-based, real-time quality assessment service that calculates quality of care measure using clinical data aggregated through a HIE. LBNH used a set of draft standards to demonstrate automated quality reporting, but noted three important recommendations for future work. First, greater coordination is needed around initiatives that address the gaps in electronic quality measurement standards and processes, including strong Federal involvement and guidance. Second, a harmonized, evergreen quality use case is needed to provide stakeholders with a common understanding on the constantly evolving approaches towards automated quality measurement and reporting. Finally, there needs to be substantial investment in building on existing work and developing a comprehensive set of data and messaging standards to preserve semantic interoperability of quality measure data.
The Scientific Assembly and Annual Meeting of the Radiological Society of North America includes many exciting scientific sessions and educational exhibits. None is greeted with more anticipation than the Sunday afternoon Image Interpretation Session. Again this year, the session will include 10 unknown cases, two each in the classic radiologic categories of genitourinary, gastrointestinal, chest, musculoskeletal, and neurologic imaging. The cases were chosen to challenge the panelists and to provide a stimulating learning experience for the attendees. Representative images are reprinted here along with pertinent clinical case histories. The panelists have been asked to describe the imaging abnormalities and the pertinent negative findings in each case. Each panelist will construct a differential diagnosis and enumerate the points in favor or against each diagnosis before committing to a most likely final diagnosis. Additional tests or treatment options may be suggested, as emphasis is placed on the practical approach to patient care.
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