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ForwardEvolving Measures From Paper to Fully Executable Software Using Digital Quality Measures & FHIR
Evolving Measures From Paper to Fully Executable Software Using Digital Quality Measures & FHIR
NCQA has a vision to transform today’s quality infrastructure by using the Fast Healthcare Interoperability Resources (FHIR) standard, which enables better exchange of electronic health information and aligns with new regulations that support interoperability between payers and providers. 1upHealth and Network Health, a Wisconsin-based health plan that is an early FHIR innovator, have partnered with NCQA on a pilot project as part of NCQA’s digital Quality Measures (dQM) program.
This vision of containerized dQMs is being piloted and proven against real-world systems and data that would enable the industry to support the rich, dynamic and generative ecosystem of quality-focused applications. This session will provide early lessons and results of the pilot partnership.
The expected reduction in costs through elimination of manual processes will allow health plans and clinicians to focus resources on providing more value for members through higher quality, more personalized and more affordable care.
Lessons from the pilot project also advance government policy goals of using clinical and payer data to enable powerful, data-driven, real-time health interventions made possible by dQMs. Network Health will discuss how this effort fits into a broader strategy and mission to be more than risk diversifiers and transaction processors. The company strives to help its members live longer, healthier lives, and NCQA's vision of evolution to tomorrow's digital quality system provides a path to accomplish that mission.
Dr. Don Rucker, MD, MBA, MS
Dr. Don Rucker is Chief Strategy Officer at 1upHealth. He recently served as the National Coordinator at ONC where he led the writing of the ONC 21st Century Cures Act Interoperability Rules. Dr. Rucker has practiced emergency medicine for 30 years and is currently on the adjunct faculty at the Ohio State University Dept of Emergency Medicine. He is a graduate of Harvard College, the University of Pennsylvania School of Medicine and is board certified in emergency medicine, internal medicine and clinical informatics. He has an MBA and an MS in medical computer science, both from Stanford.
Dr. Brad Ryan, MD
Brad is a physician-turned-business leader, focused on innovation at the intersection of clinical medicine, analytics, and technology to bring intelligence solutions to health enterprises. Brad holds broad perspective across healthcare sectors, thought leadership in digital transformation, and experience building and growing digital health businesses at Apervita, IMS Health, McKinsey & Company. At NCQA, Brad leads the product portfolio, strategy, and digital platform.
Elizabeth Strachota Benz
Elizabeth has more than 17 years industry experience and leads accreditation, appeals and grievances, condition management, credentialing, member wellness, provider informatics, quality health integration and CMS Stars areas for Network Health. Most recently she served as vice president government relations and product development, overseeing Network Health’s government relations activities, product design and supplemental benefit vendors. Prior to Network Health, Elizabeth served on the senior leadership team at Molina Healthcare of Wisconsin and vice president of sales at Universal American.
Elizabeth received a bachelor of science in both marketing and international relations from Syracuse University. She was named one of Milwaukee’s “40 under 40” in 2019 by the Milwaukee Business Journal. She currently serves as a board member for Luther Manor and Journey House, is a member of Impact 100 and serves on Tempo Milwaukee’s Professional Development Committee. Previous board and leadership roles include Wisconsin Women in Government and American Heart Association Go Red for Women Executive Leadership team.