OnDemand: Using Natural Language Processing to Achieve HEDIS...
Using Natural Language Processing to Achieve HEDIS Year-Round Review
In 2018, UPMC Health Plan set a strategic goal to move to prospective, year-round HEDIS review for hybrid measures, across Medicare, Medicaid and SNP business lines. To support this strategic goal, the UPMC Health Plan Quality team worked with technology innovators at UPMC Enterprises to apply Natural Language Processing to HEDIS hybrid abstraction. Working together, UPMC teams developed a unique technology platform that markedly increases abstractor efficiency in closing gaps. The system is currently in production use at UPMC Health Plan across 12 measures and 3 lines of business. This course discusses the use of natural language processing for HEDIS, as well as lessons learned after introducing NLP into real-world HEDIS workflows.
Click here to access the Quality Innovation Series registration page to register or review the full course content.
- Define natural language processing and how it extracts information from clinical documents to support HEDIS operations.
- Describe the development process UPMC implemented to support year-round review of HEDIS processes using an innovative technology platform.
- List at least three lessons learned about the year-round HEDIS review process.
Director, Quality Improvement
UPMC Health Plan
Lisa Gerdes, Director, Clinical and Regulatory Quality Improvement, has over 20 years experience in health plan quality improvement. She currently oversees UPMC Health Plan's annual HEDIS medical record review campaign, including the HEDIS audit and submission process, and year-round HEDIS chart review, utilizing a Natural Language Processing system. She is responsible for NCQA Health Plan Accreditation, including LTSS Distinction, and Multicultural Healthcare Distinction (soon to be Health Equity Accreditation). Additionally, Lisa oversees the clinical team responsible for Quality of Care (QOC) patient safety investigations, remediation, and improvement plans.
Dr. Rebecca Jacobson is President of Astrata, a healthcare technology company and spin out of UPMC. Astrata helps Health Plans use NLP and advanced analytics to transform their HEDIS quality measurement program to Digital Quality. Dr. Jacobson was previously Vice President at UPMC Enterprises, where she oversaw the analytics program. And before that Dr. Jacobson was Professor of Biomedical Informatics and Chief Information Officer for the Institute for Personalized Medicine at University of Pittsburgh School of Medicine. Over the past twenty years, Dr. Jacobson’s work has focused on extracting meaningful information from electronic medical records to impact population health, precision medicine, and quality improvement, using NLP methods. She is an elected Fellow of the American College of Medical Informatics (since 2010).
In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), and the Association of Social Work Boards (ASWB) to provide Interprofessional Continuing Education for the healthcare team.
This educational activity is approved for a maximum of 1.0 AMA PRA Category 1 Credit™.
This educational activity is approved for 1.0 nursing contact hours.*
This live course grants 1.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.
* Please note – You must attend the entire program to be eligible for total number of contact hours.
Disclosure of Relevant Financial Relationships
The National Committee for Quality Assurance (NCQA) endorses the Standards of the Accreditation Council for Continuing Medical Education which specify that sponsors of continuing medical education activities and presenters at and planners for these activities disclose any relevant financial relationships either party might have with commercial companies whose products or services are discussed in educational presentations.
For sponsors, relevant financial relationships include large research grants, institutional agreements for joint initiatives, substantial gifts, or other relationships that benefit the institution. For presenters or planning committee members, relevant financial relationships include the receipt of research grants from a commercial company, consultancies, honoraria, travel, or other benefits, or having a self-managed equity interest in a company; or having an immediate family member or partner with such a relationship.
Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.
Relevant financial relationships exist with the following companies/organizations:
Lisa Gerdes: None
Rebecca Jacobson: Yes (Astrata, Inc.)
Additional Planning Committee Members:
Tammy Donnelly: None
This program was developed in part by NCQA staff.
This program received no commercial support.
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC
- 1.00 Participation
- 1.00 PCMH CCE