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Appendix D: Evaluation of State Strategies

Short-Term Outcome Measures

These measures are intended to measure the immediate outcomes of state efforts to improve information exchange, including changes in provider incentives, health information exchange occurring between providers, and provider perception of health information sharing and health care markets. Measures are presented in categories according to the types of outcomes they seek to achieve.

Information Exchange Measures

Provider to Provider Exchange via EHRs
  • Number and percent of providers in a state that have adopted an EHR by provider type and EHR vendor
    • Including number and percent of behavioral health providers (social workers, community mental health centers, psychiatric hospitals/units, residential treatment centers, psychologists) using an EHR.
  • Number and percent of providers in a state exchanging information using an EHR by provider type and EHR vendor
    • Within networks
    • Across networks
  • Number and percent of providers participating in EHR Incentive Programs
    • Number and percent of providers meeting Meaningful Use milestones
  • Types of data being exchanged (labs, CCDs, ADTs, discharge summaries, imaging reports, referrals, screening assessments, psychiatric evaluations, discharge/transition plans, progress notes)
  • Number and percent of admissions, discharges and transfers that have an associated ADT notification going to a provider
Provider to Provider Exchange via HIOs
  • Number and percent of provider organizations participating with an HIO:
    • Number and percent of providers retrieving data from an HIO via a viewer or portal, including provider success rate for querying and retrieving data on their patients from the viewer or portal
    • Number and percent of providers retrieving data from an HIO through their own EHR
    • Number and percent of providers sending information to HIO(s) on a regular basis
  • Number of patients whose data are being exchanged via HIO
  • Ability for interstate HIO information sharing
  • Volume of information sharing occurring between HIOs across state lines
Provider Adoption and Perception Measures
  • Ease of EHR technology adoption
  • Ease of incorporating EHR technology into health care provider and support staff workflow
  • Ability to meaningfully use patient data received through exchange
  • Satisfaction with practice transformation efforts related to data exchange
Delivery System Reform Measures
  • Implementation of delivery and payment reforms to incentivize value
    • Percent of providers’ revenue tied to VBP arrangements
    • Number and type of VBP arrangements occurring in the state
    • Number and type of providers participating in VBP arrangements
    • Number of patients receiving care under a VBP arrangement