Driving Quality and Performance Measurement—
A Foundation for Clinical Decision Support: A Consensus Report
i National Quality Forum
INCREASING DEPLOYMENT, ADOPTION, AND MEANINGFUL
use o electronichealth records (EHRs) and health IT systems in the United States oers great potential to im-prove the quality, saety, and eectiveness o healthcare. An important means to advancethis goal is to measure perormance, ensuring that relevant clinical knowledge is availableat the point o care and implemented in a manner that promotes optimal care delivery. Todo so, EHRs must, at a minimum, capture and make available essential inormation tradi-tionally ound in paper medical records and then match patient inormationwith relevantclinical knowledge, thereby helping users incorporate that knowledge into decisionmaking.Clinical decision support (CDS) is an essential capability in health IT systems that makesthis possible. However, achieving this goal requires that CDS users dene and understanddecision support in the same way, that is, share a common description o CDS. A commondescription, classication, or “taxonomy” o CDS should assist health IT system developers,system implementers, and the quality improvement community to develop tools, content,and procedures that are compatible and enable comprehensive use o CDS, therebyimproving delivery o appropriate, evidenced-based care.In November, 2009, the National Quality Forum (NQF) convened the CDS Expert Panel,with broad representation rom the healthcare community, to develop a taxonomy or CDS.The CDS Expert Panel builds on the work o NQF’s Health Inormation Technology ExpertPanel (HITEP), which developed the Quality Data Set (QDS). The QDS is an inormation
model that lays the oundation or automatic, patient-centric, longitudinal quality measurement.
This document describes the development o the NQF CDS Taxonomy, the relationshipbetween quality measurement and CDS, and the mapping o the Taxonomy to the QDSModel.NQF thanks the CDS Expert Panel, the Expert Panel’s Chair, Michael Krall, MD, andVice Chair, Jane Metzger, and NQF members or their contributions to the development oa CDS taxonomy that builds a relationship between quality measurement and clinicaldecision support.
Janet M. Corrigan, PhD, MBAPresident and Chie Executive Ofcer